CT小肠造影在炎症性肠病中的诊断价值

Diagnostic value of CT enterography in inflammatory bowel disease

目的探讨结肠镜及CT小肠造影(CTE)在炎症性肠病(IBD)诊断中的价值。方法选取昆明医科大学第一附属医院消化内科2017年9月至2019年9月经内镜及病理检查确诊的IBD患者为研究对象,其中溃疡性结肠炎(UC)患者68例,克罗恩病(CD)患者37例,回顾性分析所有患者的结肠镜及CTE表现。结果105例患者均完成结肠镜检查,其中有28例UC患者进一步完成CTE检查,有30例CD患者进一步完成CTE检查。疾病活动性分级为轻度、中度、重度UC患者的改进的Baron分级标准评分比较,差异有统计学意义(F=0.748,P<0.001);疾病活动性分级为轻度、中度、重度CD患者的SES-CD评分比较,差异有统计学意义(F=0.646,P<0.001)。UC患者以对称性增厚为主,CD患者以非对称性增厚为主,且CD患者较UC患者更易发现肠管僵直、梳妆征及肠周渗出等(P<0.05)。疾病活动性分级为轻度、中度、重度UC患者的CTE下管壁总厚度比较,差异无统计学意义(P>0.05);疾病活动性分级为轻度、中度、重度CD患者的CTE下管壁总厚度比较,差异无统计学意义(P>0.05)。结论CTE能客观评价肠道炎症垂直扩散程度及肠外表现,结肠镜结合CTE有助于IBD的诊断。

Objective To investigate the value of colonoscopy and C T enterography(CTE)in the diagnosis of inflammatory bowel disease(IBD).Methods Totally 68 cases of ulcerative colitis(UC)and 37 cases of Crohn′s disease(CD)were selected.The colonoscopy and CTE findings were retrospectively analyzed.Results All 105 patients completed colonoscopy,of which 28 patients with UC completed further CTE examination,and 30 patients with CD completed further CTE examination.The improved Baron grading standard score comparison of patients with disease activity classification as mild,moderate,and severe UC,the difference was statistically significant(F=0.748,P<0.001);the disease activity classification was mild,moderate,and severe The SES-CD scores of CD patients were compared,and the difference was statistically significant(F=0.646,P<0.001).UC patients are mainly symmetrical thickening,and CD patients are mainly asymmetrical thickening,and CD patients are more likely to find bowel stiffness,dressing signs and peri-intestinal oozing than UC patients(P<0.05).The total thickness of the CTE inferior tube wall of patients with disease activity classified as mild,moderate,and severe UC was compared,and the difference was not statistically significant(P>0.05);the total thickness of the CTE inferior tube wall of patients with disease activity classified as mild,moderate,and severe CD showed no statistical significance(P>0.05).Conclusion CTE can objectively evaluate the vertical spread of intestinal inflammation and extraintestinal manifestations.Colonoscopy combined with CTE is helpful for the diagnosis of IBD.