MR小肠造影联合弥散加权成像诊断儿童肠白塞病

MR enterography combined with diffusion-weighted imaging for diagnosing intestinal Behcet's disease in children

目的观察MR小肠造影(MRE)联合弥散加权成像(DWI)诊断儿童肠白塞病(BD)的价值。方法回顾性分析经临床确诊的9例肠BD患儿,观察其MRE及DWI表现。结果MRE显示5例病灶位于回肠末端和回盲部,表现为深大溃疡;4例累及多部位,包括横结肠、升结肠、降结肠、乙状结肠等。9例病变局部肠壁均增厚,3例伴息肉样增生。DWI中,8例病灶呈高信号,1例中等信号;增强后7例病灶明显均匀强化,2例中度强化。9例中,3例见肠系膜淋巴结肿大,2例病灶邻近腹膜、肠系膜增厚强化,1例局部肠腔狭窄,1例小肠系膜侧血管增粗强化而呈“梳齿征”。结论MRE结合DWI有助于诊断儿童肠BD。

Objective To explore the value of MR enterography(MRE)combined with diffusion weighted imaging(DWI)for diagnosing intestinal Behcet's disease(BD)in children.Methods Data of 9 children with clinically diagnosed intestinal BD were retrospectively analyzed,and MRE and DWI manifestations were observed.Results MRE showed that the lesions located at the terminal ileum and ileocecal part in 5 cases present as deep large ulcers,while multiple intestinal tract involvements,including transverse colon,ascending colon,descending colon and sigmoid colon,etc.,were found in other 4 cases.The involved intestinal wall thickened in all 9 cases,including 3 cases with polypoid hyperplasia.High signal lesions on DWI were noticed in 8 cases,and equal signal lesions were found in 1 case.After administration of contrast agent,obvious uniform enhancement of lesions occurred in 7 cases,while moderate enhancement was detected in 2 cases.Mesenteric lymph nodes enlargement were detected in 3 cases,thickened and enhancement of peritoneum and mesentery were found in 2 cases,local intestinal stenosis was found in 1 case,and thickened and strengthened small mesenteric vessels was noticed in 1 case,presented as"comb tooth sign".Conclusion MRE combined with DWI could be used for diagnosing intestinal BD in children.