能谱CT在鉴别克罗恩病肠道与正常肠道的诊断价值研究

Diagnostic value of spectral CT on differential diagnosis for Crohn's disease and normal individual

目的分析能谱CT在鉴别病变累及回肠的克罗恩病肠道与正常肠道的价值。方法回顾性分析2011年1月～2012年1月经肠镜、胶囊内镜及病理检查确诊为克罗恩病的患者20例（研究组），所有患者病变均位于回肠，其中男性16例.女性4例，平均年龄35岁；收集11例由内镜或手术排除消化系统病变的患者作为对照（对照组），其中男性5例，女性6例.平均年龄34.55岁。所有患者均行能谱CT检查.测量两组患者肠壁及同层面血管的碘浓度、水浓度及单能量CT值（40～140ke V,间隔10keV）.并计算能谱曲线斜率，应用GraphPadPrism5统计软件分析两组间差异。结果研究组碘浓度值、水浓度值及单能量CT值显著高于对照组（t=2.09。5.16；P〈0.05）。两组间能谱曲线斜率比较，差异有统计学意义（t=3.16.P=0.004）。研究组与对照组血管的碘浓度值、水浓度值及单能量CT值比较，差异无统计学意义（t=0.30～1.20，P〉0.05）。结论能谱CT对于鉴别克罗恩病肠道及正常肠道患者具有诊断价值。

Objective To evaluate the role of spectral CT in differential diagnosis between Crohn＇s disease（CD） and normal controls. Methods A total of 20 CD patients（CD group） were enrolled, included 16 males and 4 females, with mean age of 35 years old, they were diagnosed as CD by examination of endoscope, capsule endoscope and pathology from January 2011 to January 2012, and the lesions were located in ileum. Eleven cases excluded by endoscope or surgical lesions with digestive system were set as normal controls（control group）, included 5 males and 6 females with a mean age of 34.55 years old. All of them underwent spectral CT examination, each spectral CT imaging included the iodine concentration, water concentration and CT attenuation（40 - 140 keV, interval was 10 keV） of ileum, aorta and the same slice level, the spectrum curve slope was calculated, and differences between 2 groups were analyzed by GraphPad Prism 5. Results The iodine concentration, water concentration and CT attenuation in ileum of CD group were significantly higher than those of control group at portal venous phase（t = 2.09 - 5.16; P 〈 0.05）. The spectrum curve slope had statistically significant differences between CD group and control group（t = 3.16, P = 0.004）. The iodine concentration, water concentration and CT attenuation in aorta showed no statistically significant differences between CD group and control group（t = 0.30 - 1.20, P 〉 0.05）. Conclusion It is demonstrated that spectral CT has diagnostic value in discriminating normal from CD in portal phase scanning.