多层螺旋CT小肠灌肠造影测量小肠肠壁厚度在克罗恩病诊断中的应用研究  

Measurement of bowel wall thickness by MSCTE application study in diagnosis of Crohn disease

作　　者：唐水英[1] 

机构地区：[1]广州市第十二人民医院放射科,510620

出　　处：《实用医学影像杂志》2015年第4期294-297,共4页Journal of Practical Medical Imaging

摘　　要：目的通过测量获得克罗恩病患者组壁厚/管径的比值,与健康组壁厚/管径的比值相比较,寻找在克罗恩病中判断肠壁增厚比值的临界点。方法收集我院进行腹部CT检查,通过病理和临床确诊为克罗恩病患者共68例,非肠道病变而进行腹部多层螺旋CT检查者5例,所有患者常规CT平扫后行增强扫描,测量肠管管径(肠管外径)、肠壁厚度,统计学相关,受试者工作曲线(ROC)克罗恩病患者组小肠管壁/管径与健康组小肠管壁/管径的关系,寻找在克罗恩病中判断肠壁增厚的临界点。结果健康组及病变组肠壁厚度/管径与肠壁厚度呈现正相关,经线性相关分析,病变组相关系数r为0.580,P值<0.05,而健康组r为0.573,P值<0.05。通过ROC曲线分析,发现冠状位比值>0.235,诊断为病变,灵敏度94.2%,特异性达91.7%,曲线下面积0.973;横断位比值>0.286,诊断为病变,灵敏度72.1%,特异性达91.7%,曲线下面积0.89。结论该预测概率模型有较高的诊断价值。Objective To get the critical point to decide the thickening of bowel wall by the comparison of the ratio of bowel wall thickness/loop diameter in patients with Crohn＇s disease and in normal controls. Methods Sixtyeight patients underwent abdominal CT examination and be diagnosised CD by clinical and pathology at our institution. Five patients tlnderwent abdominal CT examination and not be diagnosised bowel disease at our institution during the same period. All scanning was performed with and without contrast injection, Measurement index include transverse diameter, wall thickness The ratios of wall thickness/loop diameter were compared and analyzed. Results The ratio of wall thickness/loop diameter and wall thickness in patients with Crohn＇s disease and in normal controls showed the trend of positive correlation. The correlation coefficient were 0.580 （P〈0.05） and 0.573 （P〈0.05） in patients with Crohn＇s disease and in normal controls. ROC curve analysis displayed that if the ratios 〉 0.235 on coronal scans was regarded as critical point, the sensitivity, specificity and area under the curve were 94.2%, 91.7% and 0.973 respectively. Similarly, if the ratios 〉0.286 on transverse scans was considered as critical point, the sensitivity, specificity and area under the curve were 72.1%, 91.7% and 0.89 respectively. Conclusion So the results suggested that the predicted probability model has a high diagnostic value.

关 键 词：小肠 体层摄影术 X线计算机 受试者工作曲线 

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