多层螺旋CT在克罗恩病诊断中的临床应用价值

Multislice CT diagnosis of Crohn's disease

目的探讨多层螺旋CT在克罗恩病(Crohn's disease)诊断中的临床应用价值。方法回顾性分析经临床、肠镜或病理证实的49例肠道CD患者的多层螺旋CT征象,评价多层螺旋CT检查在诊断Crohn's disease中的价值。结果横断面三期扫描及多层面重建观察,小肠型28例,回结肠型14例,结肠型7例。49例患者肠壁均节段性增厚,增强后均明显强化,强化方式主要是环形分层强化,病变周围系膜水肿40例,肠系膜周围淋巴结肿大46例,假憩室5例。最大密度投影(maximum intensity projection)肠系膜血管增多、增粗38例。并发肠瘘5例、不全性肠梗阻2例。结论多层螺旋CT检查在肠道Crohn's disease的定位、分型、分期、病变范围显示的诊断中具有重要意义,对肠道克罗恩病治疗后随访有重要的价值。

Objective To assess the value of multislice CT enterography in the diagnosis of Crohn＇s disease. Methods Fortynine patients with Crohn＇s disease subsequently confirmed by endoscopy, pathology and clinical follow-up underwent triple-phase contrastenhanced multislice CT with muhiplanar reconstruction. Results The small intestine was diseased in 28 patients, both ileum and colon in 14, colon in 7. Segmental bowel wall thickening was observed in all 49 patients with annular or laminated contrast enhancement in the arterial phase. Other findings included adjacent mesenteric edema （40）, fistula （5）, mesenteric lymph node hyperplasia （46）, intestinal obstruction （2）, and pseudodiverticulum （5）. On the maximum intensity projection images, typical comb sign was found in 38 patients. Conclusions Multi-slice CT enterography is useful in demonstrating the extent and severity of Crohn＇s disease.