CT小肠造影在克罗恩病诊断中的临床价值  

Value of CT enteroclysis in the diagnosis of Crohn disease

作　　者：杜国忠[1] 朱北川[1] 

机构地区：[1]江苏省扬中市人民医院影像科,212200

出　　处：《实用医学影像杂志》2015年第4期323-326,共4页Journal of Practical Medical Imaging

摘　　要：目的总结与评估CT小肠造影(CTE)在克罗恩病(Crohn's disease,CD)临床诊断中的应用价值。方法回顾性分析18例CD患者的病史资料,分析与总结CD患者CTE的影像学特点,并与结肠镜、小肠镜等结果进行比较分析。结果 CTE诊断14例,阳性率为78%,克罗恩病CTE常见的表现为节段性肠壁增厚12例(86%)、双层或多层强化(10例,71%)、肠系膜淋巴结肿大(8例,57%)、肠系膜血管梳状征(6例,43%)、肠腔狭窄(5例,36%),肠瘘和炎性肿块形成(2例,14%)。7例(50%)CTE与结肠镜发现病变部位一致,4例(29%)CTE可见末端回肠病变而结肠镜下未见异常,结肠镜与CTE二者联合诊断16例(89%)。18例中有5例行小肠镜检查,结果显示5例CD患者CTE发现的病变部位均与小肠镜一致。结论 CTE联合常规结肠镜检查可有效而全面的评估CD患者的病情,尤其对于小肠病变的发现以及疾病的评估等方面,CTE有重要价值。Objective To evaluate the value of CT enteroclysis（CTE） in the diagnosis and assessment of Crohn＇s disease （CD）. Methods The clinical and imaging data for 18 patients with CD were retrospectively analyzed.CTE imaging features were compared with results of colonoscopy and enteroscopy. Results The rate of detection of CD by CTE was 78%. Imaging findings included intestinal wall thickening in 12 cases （86%）, mural stratification en- hancement in 10 cases （71%）, lymph node swelling in 8 cases （57%）, comb sign in 6 cases （43%）, and intestinal stenosis in 5 cases （36%）, Fistula and inflammatory mass in 2 cases （14%）. CTE features were consistent with colonoscopy results in 7 cases（50%）. However, 4 cases （29%） tested positive by CTE but negative by colonoscopy in founding small bowel lesions. The combined detection rate for CTE and colonoscopy was 89%. Five patients underwent enteroscopy, and the enteroscopy findings on the location of lesions were completely consistent with those of CTE in all 5 cases. Conclusion CTE and colonoscopy can be used to effectively and comprehensively assess CD condition, and CTE is helpful in detection of small intestinal lesions and evaluation of disease.

关 键 词：体层摄影术 螺旋计算机 CROHN病 双气束小肠镜 结肠镜 

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