CT小肠造影对克罗恩病疗效评估的价值  

Evaluation of Crohn’s disease treatment efficacy with CT enterography

作　　者：闻芳[1] 肖福霞 彭鲲[1] 徐亚利 汤光宇[1] 费祎 WEN Fang;XIAO Fuxia;PENG Kun;XU Yali;TANG Guangyu;FEI Yi(Department of Radiology,Shanghai Tenth People’s Hospital,Shanghai 200072,China;Department of Radiology,Shanghai Mental Health Center,Shanghai 200030,China)

机构地区：[1]上海市第十人民医院放射科,上海200072 [2]上海交通大学医学院附属上海精神卫生中心放射科,上海200030

出　　处：《实用放射学杂志》2024年第8期1300-1303,共4页Journal of Practical Radiology

摘　　要：目的探讨CT小肠造影(CTE)在克罗恩病(CD)临床疗效评估中的价值。方法选取经临床及病理证实的CD患者55例。所有患者在治疗前后均行CTE检查及内镜检查。根据克罗恩病活动指数(CDAI)将治疗后患者分为疗效好组与疗效差组。分析所有患者治疗前后CT影像表现。结果55例CD患者治疗前后肠壁厚度、肠壁强化程度、肠壁增厚类型、“梳征”差异有统计学意义(P<0.05)。治疗后患者肠周蜂窝组织炎、脓肿、肠系膜淋巴结增大、瘘管形成发生率(2%、2%、9%、0%)均小于治疗前(18%、7%、27%、2%)。疗效好组与疗效差组肠壁厚度、肠壁强化程度、肠壁增厚类型、“梳征”差异有统计学意义(P<0.05)。疗效好组与疗效差组logistic回归分析及受试者工作特征(ROC)曲线分析结果均显示肠壁厚度、肠壁强化程度、肠壁增厚类型是判定CD患者临床疗效的有效指标。结论CTE能够清楚地显示肠管病变及肠外并发症,并对评估患者临床疗效具有重要价值。Objective To explore the value of CT enterography(CTE)in the clinical treatment efficacy evaluation of Crohn’s disease(CD).Methods A total of 55 patients with CD confirmed by clinical and pathology were selected.All patients both underwent CTE and enteroscopy before and after treatment.After treatment,the patients were divided into the good curative effect group and the poor curative effect group according to Crohn’s disease activity index(CDAI).The CT findings were both analyzed before and after treatment.Results There were significant differences in bowel wall thickness,bowel wall attenuation,bowel wall thickness type and“comb sign”of 55 CD patients before and after treatment(P<0.05).After treatment,phlegmon,abscess,swollen lymph node enlargement,and intestinal fistula all decreased from 18%,7%,27%,and 2%to 2%,2%,9%,and 0%,respectively.Also,there were significant differences in bowel wall thickness,bowel wall attenuation,bowel wall thickness type and“comb sign”between the good curative effect group and the poor curative effect group(P<0.05).Logistic regression analysis and receiver operating characteristic(ROC)curve analysis showed bowel wall thickness,bowel wall attenuation and bowel wall thickness type were the most valuable parameters for the treatment efficacy evaluation of CD patients.Conclusion CTE can fully show intestinal lesions and extrenteral complications,and is of great value in evaluating clinical treatment efficacy of patients.

关 键 词：克罗恩病 疗效 计算机体层成像 

分 类 号：R574[医药卫生—消化系统] R814.43[医药卫生—内科学]