克罗恩病CT小肠造影表现与活动指数的相关性  

Correlations between CTE features and clinical activity index of Crohn＇s disease

作　　者：涂慧娟[1] 边联龙[1] 黄永志[1] 沈星[1] 屠建春[1] 

机构地区：[1]南京中医药大学附属昆山市中医医院放射科,江苏昆山215300

出　　处：《实用放射学杂志》2016年第3期373-376,422,共5页Journal of Practical Radiology

摘　　要：目的评估克罗恩病（CD）CT小肠造影（CTE）表现与临床活动性的相关性。方法回顾性分析37例CD患者的临床、CTE资料，根据临床活动性分类进行分组，观察中度活动期、重度活动期和缓解期3组的肠壁、肠外及并发症影像学表现，经统计学分析，评价影像表现与临床活动性的相关性。结果37例中，中度活动期患者18例，重度活动期10例，缓解期9例，共147个肠段受累，121个肠段肠壁增厚（肠壁≥4mm），平均厚度约（12．1±3．2）mm。42个肠段为3层状，71个为双层状，34个无分层。20例患者观察到肠系膜淋巴结肿大。27例出现肠系膜末梢直小血管增多密集，呈齿梳征。22例出现肠管周围脂肪密度增高。4例腹腔脓肿，7例瘘管，16例肠梗阻或狭窄，17例肛周脓肿或肛瘘等肛周病变。中度活动期、重度活动期及缓解期3组间肠壁分层、肠壁增厚、齿梳征、肠系膜脂肪密度增高、腹腔脓肿、肠腔狭窄及肠梗阻等征象有统计学差异。结论CTE能显示CD肠壁、肠外改变和并发症情况，有助于缓解期及活动期CD的鉴别。Objective To evaluate correlations between CT features and clinical activity index of Crohn＇s disease（CD）. Methods The CTE datasets from 37 patients with moderate active, severe active and remission stages CD were retrospectively analyzed. To observe imaging features of intestinal wall, parenteral and complications. And analyze whether there was an association between imaging findings and clinical activity. Results A total of 147 bowel segments in 37 cases were involved. Wall thickening （intestinal wall≥4 ram） were observed in 121 segments. An average thickness was （12.1±3.2） ram. There are 42 bowel segments of trilaminar mural stratification, 71 of the double-layed stratification and 34 of non-stratification. Enlarged mesenteric lymph nodes were observed in 20 patients. Comb sign was observed in 27 patients. Higher density of surrounding fat appeared in 22 cases. The other 37 cases inluced 4 cases with abdominal abscess,7 cases with fistula, 16 cases with intestinal obstruction or stenosis and 17 cases of perianal disease. The intestinal stratification, wall thickening, comb sign, mesenteric fat density increased, abdominal abscess, intestinal stenosis and obstruc- tion were closely associated with clinical activity. Conclusion CTE images could provide information about intestinal wall,parenteral changes and complications of Crohn＇s disease,and effectively help identifying remission and active stages of Crohn＇s disease.

关 键 词：克罗恩病 CT小肠造影 小肠 

分 类 号：R574[医药卫生—消化系统] R814.42[医药卫生—内科学]