多层螺旋CT三维成像对克罗恩病的诊断及活动性评估的价值研究  

Value of three-dimensional multi-slice spiral computed tomography imaging in the diagnosis and activity evaluation of Crohn’s disease

作　　者：李国华 朱玉春 方军 王建良 Li Guohua;Zhu Yuchun;Fang Jun;Wang Jianliang(Department of Radiology,Kunshan First People′s Hospital,Kunshan 215300,China)

机构地区：[1]江苏省昆山市第一人民医院放射科

出　　处：《中国医师杂志》2019年第10期1490-1494,共5页Journal of Chinese Physician

基　　金：昆山市2015年社会发展科技计划项目(KS1529);江苏大学2016年度医学临床科技发展项目(JLY20160046)~~

摘　　要：目的探讨多层螺旋CT三维成像对小肠克罗恩病的诊断及其活动期与缓解期的评估价值。方法回顾性分析经消化内镜确诊的34例克罗恩病患者临床和CT资料,根据病变是否有活动性将患者分为活动期组(25例)与缓解期组(9例),比较两组患者的CT征象差异,采用χ2检验评价CT三维成像对克罗恩病及其活动性评估的诊断效能。结果活动期组患者病变肠壁分层增厚、中度强化、重度强化、溃疡、息肉、蜂窝组织炎、淋巴结肿大及木梳征的发生率均高于缓解期组,两组差异均有统计学意义(χ^2=20.193、9.018、4.986、3.947、9.551、4.986、6.766、4.986,P<0.05);缓解期组患者病变肠壁单层增厚、无强化、轻度强化、腹腔脓肿的发生率高于活动期组,两组比较差异均有统计学意义(χ^2=15.092、13.768、25.336、16.996,P<0.05),而两组腹壁积气、肠腔狭窄和扩张、肠瘘比较差异均无统计学意义(P>0.05)。结论螺旋CT三维重建成像对克罗恩病肠壁增厚、肠腔病变及肠外并发症的情况能全面、细致、直观地显示,对CD活动期与缓解期的评估指导临床治疗有重要的作用。Objective To evaluate the diagnostic value of three-dimensional multi-slice spiral computed tomography(CT)imaging in Crohn’s disease(CD)of small intestine and its active and remission stages.Methods The clinical and CT data of 34 patients with Crohn’s disease confirmed by digestive endoscopy were retrospectively analyzed.According to whether the lesions were active,the patients were divided into active group(25 cases)and remission group(9 cases).The difference of CT signs between the two groups was compared.Chi square test was used to evaluate the diagnostic efficiency of CT three-dimensional imaging for polyps and their activity evaluation of Crohn’s disease.Results The incidences of intestinal wall stratification,moderate enhancement,severe enhancement,ulcer,cellulitis,lymph node enlargement and wood comb sign in active group were higher than those in remission group(χ^2=20.193,9.018,4.986,3.947,9.551,4.986,6.766,4.986 respectively,P<0.05).The incidence of intestinal wall monolayer thickening,non-enhancement,mild enhancement and abdominal abscess in remission group was higher than that in active group,with significant difference(χ^2=15.092,13.768,25.336,16.996,P<0.05).while there were no significant difference between the two groups in the incidence of pneumoperitoneum,intestinal stenosis and enlargement(P>0.05).Conclusions Spiral CT three-dimensional reconstruction imaging can show the intestinal wall thickening,intestinal lesions and parenteral complications of Crohn’s disease comprehensively,carefully and intuitively,and play an important role in guiding clinical treatment by evaluating the active and remission stages of CD.

关 键 词：CROHN病 体层摄影术 螺旋计算机 成像 三维 

分 类 号：R73[医药卫生—肿瘤]