64层螺旋CT动态增强及三维重建技术在小肠克隆氏病中的价值  

Crohn's Disease: Evaluate by Computed Tomography with Dynamic Contract Enhancement and 3D Imaging

作　　者：卢娴[1] 刘永浩[2] 张同华[1] 陈建新[1] 徐正道[1] 蔡惠芳[1] 胡翼江[1] 陈瑛[1] 顾佳[1] 

机构地区：[1]江苏省张家港市第一人民医院影像中心,215600 [2]苏州大学附属第一医院影像中心,215002

出　　处：《现代医用影像学》2015年第1期18-21,共4页Modern Medical Imageology

摘　　要：目的:探讨64层螺旋CT动态增强及三维重建技术在小肠克隆氏病中的价值。材料与方法:28例已知或怀疑小肠克隆氏病患者行常规CT平扫加动态增强检查,原始图像传送至工作站行三维重建后处理。仔细观察肠壁异常、黏膜及黏膜下溃疡、肠周围血管、瘘道、脓肿等。结果:28例病人诊断为小肠克隆氏病,共发现54段小肠病变。在活动性病变中,22例34段病变小肠肠壁增厚和强化,3例病变小肠明显强化而没有肠壁增厚,16例小肠与肠系膜边界模糊不清,肠系膜脂肪密度增厚,8例瘘管或瘘道形成,3例腹盆腔脓肿。在3例慢性感染性病变中,3例肠腔变形/狭窄,2例肠梗阻,1例穿孔,2例瘘管形成,1例合并硬化性胆管炎,1例合并肠淋巴瘤。结论:64层螺旋CT动态增强及三维重建技术在诊断小肠克隆氏病方面具有重要意义。Purpose： The purpose of this study was to evaluate the diagnostic value of CD using 64-muhideteetor helical CT dynamic contract enhancement and 3D imaging. Materials and Methods： Twenty-eight patients known or suspected CD underwent dynamic contract enhancement, then sending 0. 625mm slices to the 3D workstation, 3D images were reconstructed. All the images were reviewed to detect abnormalities of CD. The abnormalities of the bowel wall, mucosal and submueosal ulceration, prominent perienteric vasculature, sinus tracts or fistulae, abscess were evaluated. Results： Crohn disease was diagnosed in 28 patients by CT images, and 54 inflammatory segments were revealed. In active inflammato- ry cases, the diseased bowel wall thickened and the enhancement of diseased bowel wall increased significantly in 34 inflam- matory segments of 22 cases, the enhancement of diseased bowel wall increased significantly but without the wall thickened in three patients. In 16 patients, the sharp interface between bowel and mesentery was lost and the attenuation of fat increased. Sinus tracts or fistulae were observed in eight patients, four of 28 patients demonstrated abscesses. In three chronic inflamma- tory patients, normal bowel, bowel lumen stricture, and the normal enhancement of the wall were displayed, active inflamma- tion, and Crohn＇s-related bowel neoplasia, and urologic/hepatobiliary/osseous complications. Conclusion： The abnormalities of CD and its complications can be identified by muhidetector CT with dynamic enhancement and 3D imaging, the proper use of three dimensional （3-D） technique （including volume rendering and maximum intensity projection） as a routine component of dynamic enhancement interpretation can play a vital role in improving diagnostic accuracy.

关 键 词：克隆氏病 体层摄影术 X线计算机 CTA 三维重建 容积重现 最大强度投影 瘘管 

分 类 号：R574.62[医药卫生—消化系统] R816.5[医药卫生—内科学]