CT小肠造影对于鉴别肠结核与淋巴瘤的价值研究  

The Value of CT Enterography in Differentiating Intestinal Tuberculosis from Lymphoma

作　　者：张沁 买买提明•马合木提 谭娟 Zhang Qin;Maimaitiming•Mahemuti;Tan Juan(Imaging Center,Kashgar Second People's Hospital,Kashgar,Xinjiang 844000,China)

机构地区：[1]喀什地区第二人民医院影像中心,新疆喀什844000

出　　处：《中国CT和MRI杂志》2023年第7期136-138,144,共4页Chinese Journal of CT and MRI

基　　金：喀什地区科技成果转化运用示范项目(2020kscg29);新疆维吾尔自治区卫生厅青年科技人才专项科研项目(2014Y28)。

摘　　要：目的探讨CT小肠造影(CTE)对于鉴别肠结核与淋巴瘤的价值研究。方法回顾性分析将我院2019年1月至2021年12月108例通过手术与病理检查证实的肠结核和淋巴瘤患者,其中肠结核患者有60例作为肠结核组,淋巴瘤患者有48例作为淋巴瘤组。比较肠结核组与淋巴瘤组的临床表现以及并发症,并且肠结核组与淋巴瘤组进行实验室检查,另外观察分析肠结核组与淋巴瘤组的CTE影像。结果肠结核组和淋巴瘤组的年龄、病程、城乡分布等临床资料对比,差异有统计学意义(P<0.05);肠结核组、淋巴瘤组患者的首发症状是腹痛,肠结核组患者出现纳差、乏力等主要临床症状,淋巴瘤组患者出现腹部包块等主要临床症状。淋巴瘤组的腹部包块发生率、肠穿孔发生率、由于并发症需要急诊手术治疗的患者均高于肠结核组,肠结核组的纳差发生率、乏力发生率、盗汗发生率、轻度发热发生率均高于淋巴瘤组(P<0.05);肠结核组与淋巴瘤组的血白细胞计数、血红蛋白、血清白蛋白、红细胞沉降率比较,差异无统计学意义(P>0.05);CTE影像显示,肠结核组的多节段病变发生率、肠腔狭窄发生率、分层增厚发生率、肠壁积气发生率、肠壁水肿带发生率、肠壁厚度均高于淋巴瘤组;淋巴瘤组的单层偏心增厚发生率、强化程度、肠穿孔发生率、肠套叠发生率、淋巴结肿大均高于肠结核组(P<0.05)。结论肠结核与淋巴瘤在年龄、病程、临床表现以及并发症、CTE影像中具有明显的差异性,而且CTE对鉴别肠结核与淋巴瘤的临床价值较高,但实验室指标在鉴别诊断中无特异性。Objective To investigate the value of CT enterography(CTE)in differentiating intestinal tuberculosis from lymphoma.Methods Retrospective analysis was made on 108 patients with intestinal tuberculosis and lymphoma confirmed by surgery and pathology from January 2019 to December 2021 in our hospital.Among them,60 patients with intestinal tuberculosis were treated as intestinal tuberculosis group,and 48 patients with lymphoma were treated as lymphoma group.The clinical manifestations and complications of intestinal tuberculosis group and lymphoma group were compared,and laboratory examinations were carried out between intestinal tuberculosis group and lymphoma group.In addition,the CTE images of intestinal tuberculosis group and lymphoma group were observed and analyzed.Results The age,course of disease,urban and rural distribution and other clinical data of intestinal tuberculosis group and lymphoma group were significantly different(P<0.05);The first symptom of patients in intestinal tuberculosis group and lymphoma group is abdominal pain.Patients in intestinal tuberculosis group have major clinical symptoms such as poor appetite and fatigue,while patients in lymphoma group have major clinical symptoms such as abdominal mass.The incidence of abdominal mass,intestinal perforation,and patients requiring emergency surgery due to complications in the lymphoma group were higher than those in the intestinal tuberculosis group.The incidence of anorexia,fatigue,night sweating,and mild fever in the intestinal tuberculosis group were higher than those in the lymphoma group(P<0.05);There was no significant difference in WBC count,hemoglobin,serum albumin and erythrocyte sedimentation rate between intestinal tuberculosis group and lymphoma group(P>0.05);CTE images showed that the incidence of multi segment lesions,intestinal stenosis,stratified thickening,intestinal wall gas accumulation,intestinal wall edema zone and intestinal wall thickness in intestinal tuberculosis group were higher than those in lymphoma group;The incid

关 键 词：CT小肠造影 肠结核 淋巴瘤 临床表现 

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