MSCT对克罗恩病及其肠道并发症的诊断价值

Diagnostic value of MSCT in Crohn’s disease and its intestinal complications

目的:探讨MSCT对克罗恩病(CD)及其肠道并发症的诊断价值。方法:回顾性分析经病理证实的35例CD的MSCT资料,分析病灶部位、肠壁增厚及强化方式、肠管外表现及肠道并发症。结果:35例患者中,25例行MSCT小肠造影检查,10例行CT增强扫描。病变仅位于小肠23例,同时累及小肠及结直肠10例,仅累及结直肠2例。27例表现为肠壁对称性环形增厚,8例表现为非对称性增厚。增强扫描后肠壁仅黏膜层强化11例,分层强化10例,全层强化14例。20例病变周围肠系膜密度增高,27例呈齿梳征,22例肠周淋巴结反应性增大。8例合并不全性肠梗阻,9例合并肠内外瘘,7例出现腹腔脓肿,5例合并肛瘘或肛周脓肿。结论:MSCT对CD及其肠道并发症的诊断具有较高价值,能为临床选择合理的治疗方法提供重要的影像学依据,可作为CD的首选影像学检查方法。

Objective:To investigate the diagnostic value of MSCT in Crohn’s disease and its intestinal complications. Methods:MSCT data of 35 patients with Crohn’s disease confirmed by pathology were retrospectively analyzed,and the focal sites,wall thickening and enhancement patterns,extraintestinal manifestations and intestinal complications were observed and analyzed.Results:Among the 35 patients,25 cases underwent MSCT enterography,and 10 cases underwent general enhancement examination.The lesions were located only in the small intestine in 23 cases,in the small intestine and colon in 10 cases,and only in the colon and rectum in 2 cases. 27 cases showed symmetrical annular thickening of the bowel wall,and 8 cases showed asymmetrical thickening. After enhancement,only mucosal enhancement was found in 11 cases,stratified enhancement in 10 cases and full-thickness enhancement in 14 cases. The mesenteric density around the lesion was increased in 20 cases,27 cases showed the ‘comb tooth sign’,and 22 cases showed a reactive increase in peri-intestinal lymph nodes. 8 cases were accompanied with incomplete intestinal obstruction,9 with combined intestinal and external fistula,7 with abdominal abscess,and 5 with anal fistula or perianal abscess. Conclusions:MSCT has a high value in the diagnosis of Crohn’s disease and its intestinal complications. It can provide an important imaging basis for the clinical selection of reasonable treatment.