系统性红斑狼疮累及消化道CT表现

CT manifestations of digestive tract involvement in systemic lupus erythematosus

目的观察系统性红斑狼疮(SLE)累及消化道的CT表现。方法回顾性分析17例经临床确诊为SLE累及消化道患者,均接受CT平扫,其中15例接受增强扫描,记录病变累及消化道的具体部位、肠壁厚度、CT征象及伴随表现。结果SLE累及胃8例,十二指肠2例,空肠9例,回肠9例,升结肠9例,横结肠1例,降结肠6例,乙状结肠8例,直肠8例。15例CT表现为肠壁肿胀增厚,12例可见“同心圆征”,11例见“靶征”,肠腔扩张伴积气、积液13例,其中4例肠道假性梗阻;肠系膜“梳征”或“栅栏样”改变11例,肠系膜脂肪间隙模糊9例。伴随征象包括腹腔及盆腔积液15例,胸腔积液12例,心包积液3例,肠系膜上动脉栓塞1例,脾大3例,5例存在泌尿系病变(输尿管炎性狭窄、膀胱壁增厚、双肾或输尿管积水等),肠脂垂炎3例。结论SLE累及消化道典型CT表现为消化道壁及肠系膜异常。

Objective To observe CT manifestations of systemic lupus erythematosus(SLE)involving digestive tract.Methods Data of 17 cases with SLE involving digestive tract were retrospectively analyzed.All 17 patients underwent conventional plain CT scanning,while 15 among them received contrast-enhanced CT scanning.The specific location,thickness of intestinal wall,CT signs and accompanying manifestations of the lesions involving digestive tract were recorded.Results Stomach involving was found in 8 cases,while involvement of duodenum,jejunum,ileum,ascending colon,transverse colon,descending colon,sigmoid colon and rectum were observed in 2,9,9,9,1,6,8 and 8 cases,respectively.CT manifestations included intestinal wall swelling and thickening in 15 cases,"concentric circle sign"in 12 cases,"target sign"in 11 cases,also intestinal cavity expansion with gas accumulation and fluid accumulation in 13 cases,including 4 cases of pseudo-intestinal obstruction.Mesentery"comb sign"or"barrier-like"changes were noticed in 11 cases,while mesenteric fat gap was found blurred in 9 cases.There were 15 cases with abdominal and pelvic effusion,12 of pleural effusion,3 of pericardial effusion,1 case of thrombi-embolization of superior mesenteric artery,3 of splenomegaly,5 of urinary tract abnormalities(including ureteric stenosis,bladder wall thickening,double kidney or ureteral effusion,etc)and 3 cases of epipolic appendagitis.Conclusion Abnormalities of digestive tract wall and mesentery are typical CT manifestations of SLE involving digestive tract.