多排CT小肠成像鉴别小肠结核和克罗恩病的价值  

Differential diagnosis of intestinal tuberculosis from Crohn's disease by multi-detector computed tomography enterography

作　　者：吴兴旺[1] 王侠[1] 吴礼明[1] 

机构地区：[1]安徽医科大学第一附属医院放射科,合肥230022

出　　处：《安徽医学》2017年第7期834-836,共3页Anhui Medical Journal

基　　金：安徽省高校自然基金重点项目(项目编号:KJ2011A179)

摘　　要：目的探讨多排CT小肠成像(MDCTE)特征性征象在鉴别诊断肠结核和克罗恩病中的价值。方法收集安徽医科大学第一附属医院2011年8月至2014年11月经内镜、病理确诊的克罗恩病(CD)22例、结核(ITB)25例患者临床资料。每位患者入院后均行MDCTE检查,记录并分析各种MDCTE征象,寻求鉴别诊断CD和ITB有价值的CT表现。结果 CD和ITB回盲瓣受累分别占54.5%和72.0%,累及降结肠的分别占31.8%和12.0%,累及横结肠分别占18.2%和4.0%;多节段受累患者中,CD组为63.6%,ITB为36.0%;肠系膜侧肠壁增厚在CD中占50.0%,ITB则表现为环形或肠系膜对侧增厚;60.0%的ITB患者和9.1%CD患者有淋巴结中心坏死;36.4%的CD患者出现"梳状征",ITB患者中仅有4.0%,两者差异均有统计学意义(P<0.05)。结论MDCTE征象中,病变节段数、病变累及部位、"梳状征"和淋巴结坏死情况在鉴别诊断CD和ITB中具有参考价值。Objective To evaluatethe value of multi - detector CT enterography （MDCTE） in differential diagnosis intestinal tuber-culosis （ITB） and Crohn s disease （ CD） . Methods Twenty - two CD and twenty - five ITB patients were performed MDCTE scanning, then the value of MDCTE findings in differential diagnosis of CD and ITBwas evaluated. Results In patients with CD and ITB, involved the ileo-cecal valve, descending colon and transverse colon was54. 5% and 72. 0% ,31. 8% and 12. 0% , 18. 2% and 4. 0% , respectively. There were 63. 6% CD and 36. 0% ITB patients involved multistage intestine. Lymph nodenecrosis was detected in 60. 0% ITB and 9.1% CD pa-tients. Mesenteric side bowel wall thickening in 50. 0% of CD patients and ITB patients was circular thickening. There were 36.4% CD and 4.0% ITB patients with ＂comb＂ sign, and the difference was statistically significant（P 〈0.05）. Conclusion Lesion segment number and location,＂ comb＂ sign and lymph node necrosis are valuable MDCTE findings in differential diagnosis CD and ITB.

关 键 词：克罗恩病 肠结核 CT小肠成像 多排螺旋CT 

分 类 号：R524[医药卫生—内科学]