克罗恩病的螺旋CT表现及其诊断价值

The Diagnostic Value of Spiral CT for Crohn Disease

目的通过分析克罗恩病的螺旋CT表现,探讨螺旋CT的诊断价值。材料和方法分析经肠镜、手术及病理证实的22例克罗恩病的螺旋CT表现。结果 22例克罗恩病中,4例病变在小肠,9例在结肠,9例同时累及结肠和小肠,19例呈多病灶节段性,3例呈单病灶。螺旋CT表现:所有病例肠管增厚、肠腔狭窄(16例呈非对称性,6例呈对称性),3例肠粘膜强化,15例肠壁分层(靶样征或晕轮征),6例肠周纤维脂肪增生,15例肠管外血管增粗增多(梳样征),15例肠管外蜂窝织炎形成,4例肠系膜淋巴结增大,1例腹腔炎性肿块形成,1例肠瘘形成,2例伴有腹水。结论螺旋CT可明确显示克罗恩病的肠管改变及管外并发症,对于指导临床治疗以及评价临床疗效具有重要价值。

Objective To analyze the spiral CT manifestations of Crohn＇s disease and investigate the value of the spiral CT. Materialsandmethods 22 cases of Crohn＇s disease proven by colonoscopy, surgery and pathology were analyzed by spiral CT. Results Among the 22 cases of Crohn＇s disease, the lesions of 4 cases were located in small intestinal, 9 cases were located in colon. 9 cases were located in both colon and small intestinal. 19 cases were multiple skip lesions, 3 cases were focal lesions. The features of the spiral CT were： bowel wall thickening and luminal narrowing in all cases（16 cases intestinal canal were asymmetric, 6 cases were symmetric）, 3 cases with increase enhancement of intestinal mucosa, 15 cases with mural stratification（target sign or halo sign）, 6 cases with periintestinal fibrofatty proliferation, 15 cases with perienteric hypervascularity（comb sign）, 15 cases with phlegmon, 4 cases with mesenteric lymph node enlargement, 1 case of inflammatory mass, 1 case of fistula,2 cases of ascites. Conclusion Spiral CT can exactly demonstrate the diseased bowel wall and extramural complications of crohn＇s disease, which is of important to guide the clinic treatment and to assess the effect of treatment.