多层螺旋CT肠道造影在活动期溃疡性结肠炎评估中的应用

Multi-slice Computed Tomography Enteroclysis in Evaluation of Active Ulcerative Colitis

目的总结活动期溃疡性结肠炎(UC)的多层螺旋CT肠道造影(CTE)特点,探讨多层螺旋CTE在全面评估UC中的价值。资料与方法 35例经临床、肠镜及病理证实的活动期UC患者,均行多层螺旋CTE检查,根据改良Mayo评分系统将疾病分为轻度、中度、重度,比较不同组的CTE表现。结果 35例UC患者中,轻度组6例,中度组13例,重度组16例,轻度组与中度组肠黏膜下气泡差异有统计学意义(P<0.05),中度组与重度组肠壁分层、结肠袋消失及淋巴结肿大差异有统计学意义(P<0.05),肠系膜血管增多在3组间差异均有统计学意义(P<0.05),肠壁增厚、黏膜强化程度增加、肠腔狭窄及直肠周围脂肪沉积在各组间差异无统计学意义(P>0.05)。结论多层螺旋CTE可以全面评估UC的肠壁、肠管及肠外情况,对活动期UC的诊断及临床分度判断均有较高的价值。

Purpose To summarize the characteristics of computed tomography enteroclysis（CTE） in active ulcerative colitis（UC）, and to explore the value of multislice CTE in the evaluation of UC. Materials and Methods Thirty-five patients with active UC confirmed by clinical manifestation, colonoscopy and pathology underwent CTE examination in the study. According to the modified Mayo-score, the patients were divided into mild group, moderate group and severe group, and the CTE manifestations were compared among the three groups. Results Among 35 patients, 6 patients were in the mild group, 13 in the moderate group, and 16 in the severe group. Submucosal bubbles had significant differences between mild and moderate groups（P〈0.05）, bowel wall stratification, disappearance of haustra and enlarged mesenteric lymph nodes were significantly different between moderate and severe groups（P〈0.05）, and engorged vasa recta was significantly different between the 3 groups（P〈0.05）. However, bowel wall thickening, mural hyperenhencement, narrow lumen and fatty deposits around the rectum showed no difference between the three groups（P〈0.05）. Conclusion Multi-slice CTE can provide image features of bowel wall, intestinal tube and structures outside intestine in the evaluation of UC, thus it is useful in the diagnosis of active UC as well as in its clinical grading.