小肠CT造影对克罗恩病肠道并发症的诊断价值  

Value of CT Enterography in Diagnosis of the Intestinal Complications of Crohn's Disease

作　　者：杨春静[1] 张吉林[1] 王贤 YANG Chunjing;ZHANG Jilin;WANG Xian(The First People’s Hospital of Jiujiang,Jiujiang 332000,China)

机构地区：[1]江西省九江市第一人民医院,江西九江332000 [2]江西省瑞昌市码头镇中心卫生院

出　　处：《中国医学创新》2018年第34期129-133,共5页Medical Innovation of China

基　　金：江西省卫生计生委科技计划项目(20164030)

摘　　要：目的:探讨小肠CT造影对克罗恩病肠道并发症的诊断价值。方法:对23例经临床确诊的克罗恩病患者的CT资料进行回顾性分析。所有患者均行小肠CT造影,对所得图像进行重组分析,并采用多种图像后处理技术,由两位放射科医师分析病变的影像学表现,对克罗恩病的征象及其并发症进行诊断分析,并与小肠镜及手术结果相对照。结果:23例克罗恩病患者中共38段小肠受累,正确诊断29段,敏感性76%。23例患者中发生不同程度肠梗阻者8例,肠内瘘者3例,肠外瘘者2例,腹腔脓肿者3例,肠穿孔并蜂窝织炎1例,均得到正确诊断。CTE检查诊断克罗恩病肠道并发症的敏感性及特异性分别为83%和94%。克罗恩病并发症的主要CT征象:肠壁增厚及肠腔狭窄(8/23),瘘管(5/23)、肠周环形强化病灶(3/23)、肠外气体(1/23)及肠系膜斑片状高密度影(1/23)等。结论:CTE能够显示克罗恩病不同并发症的影像学特点,在评估克罗恩病肠道并发症上具有重要价值。Objective:To explore the value of CT enterography(CTE) in the diagnosis of the intestinal complications of Crohn’s disease(CD).Method:CT data of 23 cases with clinically-diagnosed CD were analyzed retrospectively.All patients underwent CTE examination,and the obtained images were reconstructed for analysis.Multiple image post-processing techniques were used to analyze the images of lesions by two radiologists,the signs and complications of Crohn’s disease were diagnosed and analyzed,the results of colonoscopy and surgery were compared.Result:38 segments of small bowel were involved in 23 patients with CD,among witch 29 segments were diagnosed correctly.The sensitivity was 76%.The 23 patients intestinal obstruction of varying degree occurred in 8 cases,intestinal fistulas in 3 cases,external fistula in 2 cases,abdominal abscess in 3 cases,and intestinal perforation and cellulitis in 1 case,all of which were correctly diagnosed.The sensitivity and specificity of CTE in the diagnosis of intestinal complications of CD were 83% and 94% respectively.Major CT signs of the complications of CD include intestinal wall thickening and lumen stenosis(8/23),fistula(5/23), peri-intestinal lesions of ring enhancement(3/23), parenteral gas(1/23), patchy high-density in mesentery(1/23).Conclusion:CTE can reveal the imaging characteristics of different complications of CD,which is of great value in the assessment of the intestinal complications.

关 键 词：克罗恩病 体层摄影术 X线计算机 小肠CT成像 

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