多层螺旋CT小肠增强造影在诊断炎性肠病中的应用价值探讨

Discussion on the Application Value of Multi-Slice Spiral CT Enhanced Enterography in the Diagnosis of Inflammatory Bowel Disease

目的探讨多层螺旋CT小肠增强造影在炎性肠病诊断中的应用价值。方法对我院2016年1月至2019年1月收治的60例疑似炎性肠病患者的临床资料进行回顾性分析,患者均经病理检查及多层螺旋CT小肠增强造影检查。以病理结果为金标准,计算多层螺旋CT小肠增强造影检查的诊断灵敏度、特异度及符合率,记录CT小肠增强造影的图像表现。结果60例疑似炎性肠病患者中,51例确诊为炎性肠病,其中溃疡性结肠炎(UC)16例,克罗恩病(CD)35例。以病理结果为金标准,CT小肠增强造影诊断UC的灵敏度为93.75%、特异度为93.18%,诊断符合率为93.33%;CT小肠增强造影诊断CD的灵敏度为97.14%、特异度为80.00%,诊断符合率为90.00%。CT小肠增强造影显示,CD患者的肠腔狭窄、多节段性病变、肠周脂肪间隙模糊发生率高于UC患者(P<0.05),CD与UC患者的肠壁增厚、肠壁强化发生率无统计学差异(P>0.05)。结论多层螺旋CT诊断炎性肠病具有较高的应用价值,可清晰显示病灶,有效鉴别UC与CD,为治疗方案的选择提供可靠依据。

Objective To explore the application value of multi-slice spiral CT enhanced enterography in the diagnosis of inflammatory bowel disease.Methods The clinical data of 60 patients with suspected inflammatory bowel disease admitted to our hospital from January 2016 to January 2019 were retrospectively analyzed.All cases received pathological examination and multi-slice spiral CT enhanced enterography.With pathological results as the gold standard,the diagnostic sensitivity,specificity and coincidence rate of multi-slice spiral CT enhanced enterography were calculated,and the image manifestations of CT enhanced enterography were recorded.Results Of the 60 patients with suspected inflammatory bowel disease,51 cases were diagnosed as inflammatory bowel disease,including 16 cases of ulcerative colitis(UC)and 35 cases of Crohn's disease(CD).The sensitivity,specificity and coincidence rate of CT enhanced enterography in the diagnosis of UC were 93.75%,93.18%and 93.33%,respectively.The sensitivity,specificity and coincidence rate of CT enhanced enterography in the diagnosis of CD were 97.14%,80.00%and 90.00%respectively.CT enhanced enterography showed that the incidences of intestinal stenosis,multisegmental lesions and blurred periintestinal fat space of CD patients were significantly higher than those of UC patients(P<0.05),while no statistical difference was found between UC and CD patients in the incidences of thickening intestinal wall and strengthening intestinal wall(P>0.05).Conclusions Multi-slice spiral CT has high application value in the diagnosis of inflammatory bowel disease,which can clearly show the lesions,effectively identify UC and CD,and provide a reliable basis for the choice of treatment options.