CT小肠造影及MR高清弥散序列在克罗恩病和溃疡性结肠炎鉴别诊断中的应用价值  

Value of CT Enterography and MR High-resolution Diffusion Sequences in the Differential Diagnosis of Crohn's Disease and Ulcerative Colitis

作　　者：庞婧[1] 李晓莉[1] 周锐志[1] 张静[1] PANG Jing;LI Xiaoli;ZHOU Ruizhi;ZHANG Jing(Department of Radiology,the Affiliated Hospital of Qingdao University Medical College,Shandong 266003,China)

机构地区：[1]青岛大学附属医院放射科,山东266100

出　　处：《影像技术》2025年第2期58-63,共6页Image Technology

摘　　要：目的:探讨CT小肠造影及MR高清弥散序列在克罗恩病和溃疡性结肠炎鉴别诊断中的应用价值。方法:收集2020年12月至2022年3月在我院经CT小肠造影、MR小肠造影、内镜、病理证实为溃疡性结肠炎患者55例,克隆恩患者44例。比较两组患者的发病年龄、CT小肠造影和MR小肠造影及高清弥散ADC值等影像学表现的差异。结果:克罗恩病组患者发病年龄较溃疡性结肠炎组患者年龄差异具有统计学意义(P=0.00),且克罗恩病组患者年龄偏小;55名溃疡性结肠炎患者共发现82个病灶,其中回盲部12个,结直肠70个,小肠部位未发现病灶。相比之下,44名克罗恩病患者中发现了56个病灶,主要位于小肠(39个)和回盲部(8个),结直肠仅9个。克罗恩病患者的病灶主要分布在小肠,而溃疡性结肠炎患者的病灶主要在结直肠(P=0.00)。此外,在溃疡性结肠炎患者中,观察到肠管周围蜂窝织炎的病例数为12例,明显高于克罗恩病组的3例,这一差异经过统计分析具有显著性(P=0.05)。不过,两组在病变肠壁的厚度、强化表现、淋巴结的增大以及梳征这些方面,均未展现出明显的统计学差异。值得注意的是,CT小肠造影显示两组的强化CT值存在显著差异(P=0.00)。在MR小肠造影及高清弥散序列上,两组患者的T2值、ADC值和强化T1值均有显著差异(分别为P=0.00、P=0.01、P=0.00),两组平扫T1值无明显差异。结论:CT小肠造影及MR高清弥散序列在克罗恩病和溃疡性结肠炎的鉴别诊断中具有显著的应用价值。这些影像技术不仅能准确反映肠道病变的位置和范围,还能通过量化指标如ADC值、T2值和强化CT值等,有效区分克罗恩病和溃疡性结肠炎,为临床决策提供重要依据。Objective:To evaluate the value of CT enterography and MR high-resolution diffusion sequences in the differential diagnosis of Crohn's disease and ulcerative colitis.Methods:A total of 55 patients with ulcerative colitis and 44 patients with Crohn's disease were confirmed by CT enterography,MR enterography,endoscopy and pathology in our hospital from December 2020 to March 2022.The differences in age of onset,CT enterography,and MR enterography imaging and high-resolution diffusion ADC values were compared between the two groups.Results:The age difference in onset of patients in Crohn's disease group was statistically significant compared with that in ulcerative colitis group(P=0.00),and the age of patients in Crohn's disease group was younger.A total of 82 lesions were found in 55 patients with ulcerative colitis,including 12 in ileocecal region,70 in colorectal region,and no lesions in small intestine.In contrast,56 lesions were found in 44 patients with Crohn's disease,mainly in the small intestine(39)and ileocecal region(8),and only 9 in the colorectal region.Lesions in patients with Crohn's disease were predominantly located in the small intestine,while lesions in patients with ulcerative colitis were mainly found in the colon and rectum(P=0.00).In addition,among patients with ulcerative colitis,there were 12 cases of pericolic abscess observed,which was significantly higher than the 3 cases in the Crohn's disease group(P=0.05).However,there were no significant statistical differences between the two groups in terms of the thickness of the diseased intestinal wall,enhancement patterns,lymph node enlargement,and comb sign.It is worth noting that CT enterography showed a significant difference in enhancement CT values between the two groups(P=0.00).Furthermore,MR enterography and high-resolution diffusion sequences revealed significant differences in T2 values,ADC values and enhanced T1 values between the two groups(P=0.00,P=0.01,P=0.00),while there was no significant difference in plain T1 values.Conclusion:C

关 键 词：CT小肠造影 高清弥散 溃疡性结肠炎 克罗恩病 

分 类 号：R445[医药卫生—影像医学与核医学]