成人乳糜泻消化道钡餐造影的影像学特征  

Imaging Features of Gastrointestinal Barium Meal Examination in Adults with Celiac Disease

作　　者：史甜 火忠[1] 冯燕[1] 李紫琼[1] 卢加杰[1] 惠文佳[1] 刘卫东[1] 阿迪来·阿布都热西提 哈丽娜·哈力克 王英颖 高峰[1] SHI Tian;HUO Zhong;FENG Yan(People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi Xinjiang 830001)

机构地区：[1]新疆维吾尔自治区人民医院,新疆乌鲁木齐830001

出　　处：《医学临床研究》2022年第6期815-818,共4页Journal of Clinical Research

基　　金：国家自然科学基金(81760101);新疆维吾尔自治区人民医院院内项目(20200406)。

摘　　要：【目的】探讨乳糜泻(coeliac disease,CD)消化道钡餐造影的影像学特征。【方法】收集2018年6月至2020年6月新疆维吾尔自治区人民医院收治的20例CD患者的临床资料,所有患者均完善上消化道钡餐造影或全消化道钡餐造影,由2位资深影像学医师对本组患者的消化道钡餐造影表现进行分析。【结果】上消化道钡餐影像学检查显示,20例CD患者中有18例(90.0%)患者十二指肠黏膜异常,最常见的表现是十二指肠黏膜皱襞增厚,占比85.0%(17/20),多数病例可见小龛影,占比60.0%(12/20),上述异常表现以十二指肠球部及十二指肠降部最为明显。有8例表现为十二指肠降部黏膜边缘不光整,呈“锯齿状”改变,2例十二指肠有不同程度扩张。20例CD患者中有12例患者进行了全消化道钡餐检查,12例患者均有小肠黏膜异常表现。其中小肠黏膜皱襞增厚9例(75.0%),空肠皱襞减少、变浅8例(66.7%),7例(58.3%)因肠管不同程度扩张或痉挛表现为肠管粗细不均,2例(16.7%)小肠黏膜边缘不光整,呈“锯齿状”改变。【结论】消化道钡餐作为一种无创检查技术,可较好地显示CD十二指肠和小肠的异常表现,对CD的筛查有较高的临床应用价值。【Objective】To investigate the imaging features of gastrointestinal barium meal examination in celiac disease(CD)in order to improve the screening level of the disease.【Methods】The clinical data of 20 patients with celiac disease admitted to the people's Hospital of Xinjiang Uygur Autonomous Region from June 2018 to June 2020 were collected retrospectively.All patients were improved with upper gastrointestinal barium meal or total gastrointestinal barium meal.Two senior radiologists analyzed the performance of digestive tract barium meal in this group.【Results】Barium meal imaging examination of the upper gastrointestinal tract showed that 18(90.0%)of the 20 patients with CD had abnormal duodenal mucosa.The most common manifestation was thickening of duodenal mucosal folds,accounting for 85.0%(17/20).Small niches were seen in most cases,accounting for 60.0%(12/20).The above abnormal manifestations were most obvious in the duodenal bulb and the descending duodenum.In 8 cases,the edge of the descending duodenal mucosa was not smooth,showing"serrated"changes,and in 2 cases,the duodenum was dilated to varying degrees.Twelve of the 20 patients with CD underwent barium meal examination of the whole digestive tract,and 12 patients had abnormal small intestinal mucosa.Among them,9 cases(75.0%)had thickened small intestinal mucosal folds,8 cases(66.7%)had decreased and shallowed jejunal folds,7 cases(58.3%)had uneven intestinal thickness due to different degrees of intestinal dilatation or spasm,and 2 cases(16.7%)had irregular edges of small intestinal mucosa,showing"serrated"changes.【Conclusion】As a non-invasive technique,gastrointestinal barium meal can better show the abnormal manifestations of duodenum and small intestine in CD,and has high clinical value in the screening of CD.

关 键 词：乳糜泻/影像诊断 胃肠道/影像诊断 硫酸钡 

分 类 号：R597.8[医药卫生—内科学]