多层螺旋CT对肠道Crohn病的诊断价值

Value of Multi-slice Spiral CT in Diagnosis of Intestinal Crohn Disease

目的探讨多层螺旋CT(MSCT)对于肠道Crohn病(CD)的诊断价值。方法回顾性分析2010年2月至2013年2月在新乐市社会保险职工医院住院治疗的16例肠道Crohn病患者的MSCT资料,总结CD的发病部位、MSCT征象,分析CD并发症及肠外器官改变情况。结果 16例患者中,单纯小肠发病者5例(31.3%),小肠和结肠均发病者10例(62.6%),单纯结肠发病者1例(6.1%);12例为多节段性发病;16例患者均表现为不同程度的环状肠壁增厚,6例有偏心性增厚;增强扫描,7例患者肠壁呈多层状强化,6例呈双层状强化,3例为单层均一强化。肠系膜密度增高、边缘不清,并可见纤维条索影11例;系膜血管增多、扩张、扭曲及梳样征8例;合并窦道和脓肿形成者1例,不全梗阻2例;肠腔外病变有胆结石2例,肾结石1例,骶髂关节炎3例,肛周脓肿1例。结论 MSCT能够清晰显示CD患者肠壁增厚的程度、肠管分层以及强化情况,明确诊断肠系膜及肠管外病变情况,MSCT对于CD的诊断具有重要价值。

Objective To evaluate the diagnostic value of multi-slice spiral CT（MSCT） in intestinal Crohn disease（CD）. Methods Retrospective analysis of MSCT data in 16 patients with intestinal Crohn hospitalized in Xinle City Social Insurance Worker Hospital from Feb. 2010 to Feb. 2013 was done, CD sites and signs of MSCT were summarized, and the incidence of CD complications and the changes of parenteral organs were analyzed. Results Among the 16 patients,there were 5 cases with simple intesti- nal disease （31.3 % ）, 10 cases with small intestine and colon disease （62.6 % ）, 1 case with colon disease （6.1%）;there were 12 cases with multiple segmentallesions; all of the 16 patients showed different degrees of annular thickening of the intestinal wall, and 6 cases with eccentric thickening. After enhancement, there were 7 cases with multi layered enforcement of intestinal wall, 6 cases with double-layer enhancement, 3 cases with single homogeneous enhancement. There were 11 cases with increased mesenteric density, unclear edge, and visible fiber cord,8 cases with mesenteric vessels increasing, expanding, distorting and combing, 1 case with complication of sinus and abscess,2 cases with incomplete obstruction, 2 cases with extraluminal lesions and gallbladder stone, 1 cases with renal calculi ,3 cases with sacroiliac arthritis, and 1 case with pefianal abscess. Conclusion MSCT can clearly display the intestinal wall thickening,the degree of intestinal stratification and strengthening of patients with CD, and it can diagnose mesenteric lesions and lesions outside intestine clearly,therefore MSCT has an important value for CD diagnosis.