CT小肠造影影像对结肠型克罗恩病与溃疡性结肠炎的诊断价值

Comparation of CT enterography imaging features between colonic Crohn's disease and ulcerative colitis with clinical

目的探究CT小肠造影(CTE)对结肠型克罗恩病与溃疡性结肠炎的诊断及鉴别诊断价值。方法选取蚌埠医学院第一附属医院和南京中医药大学附属江苏省中医院于2019年1月~2022年1月收治的结肠型克罗恩病患者36例和溃疡性结肠炎患者36例行CTE检查,分别观察两组影像特征,结合实验室指标、临床表现对克罗恩病和溃疡性结肠炎患者进行回顾性分析。结果36例克罗恩病患者中,CTE影像示肠壁不均匀增厚21例、肠道狭窄22例、瘘管形成7例及累及升结肠21例,均高于溃疡性结肠炎患者,差异有统计学意义(P<0.05);36例溃疡性结肠炎患者,粘液便18例及血便22例高于克罗恩病患者(P<0.05),溃疡性结肠炎患者平均发病年龄较结肠型克罗恩病患者平均发病年龄大(P<0.05)。克罗恩病患者与溃疡性结肠炎患者的C反应蛋白及红细胞沉降率含量均值分别为28.17 mg/L vs 17.67 mg/L、32.25 mm/h vs 22.95 mm/h;C反应蛋白及红细胞沉降率含量的平均值对克罗恩病与溃疡性结肠炎的鉴别无统计学意义(P>0.05)。结论通过CTE影像特征更直观地对结肠型克罗恩病与溃疡性结肠炎进行鉴别,结合临床、内镜表现及病理诊断,为治疗方案设计提供更可靠的依据。

Objective To investigate the diagnostic and differential diagnostic value of CT enterography for colon-type Crohn's disease and ulcerative colitis.Methods Thirty-six patients with colonic Crohn's disease and 36 patients with ulcerative colitis admitted to the First Affiliated Hospital of Bengbu Medical College and Jiangsu Provincial Hospital of Nanjing University of Traditional Chinese Medicine from January 2019 to January 2022 were selected for CT enterography examination.The imaging features of both were observed.The patients with Crohn's disease and ulcerative colitis were retrospectively analyzed by combining laboratory indices and clinical manifestations.Results Among the 36 patients with Crohn's disease,CT enterography images showed 21 cases of uneven thickening of the intestinal wall,22 cases of intestinal stricture,7 cases of fistula formation,and 21 cases of involvement of the ascending colon were higher than those of patients with ulcerative colitis(P<0.05).Among the 36 patients with ulcerative colitis,18 cases of mucus stools and 22 cases of bloody stools were higher than those of patients with Crohn's disease(P<0.05).The mean age of onset was older in patients with ulcerative colitis than in patients with colonic Crohn's disease(P<0.05).The mean values of C-reactive protein and erythrocyte sedimentation rate in patients with Crohn's disease were 28.17 mg/L and 32.25 mm/h,respectively.The mean values of C-reactive protein and erythrocyte sedimentation rate in patients with ulcerative colitis were 17.67 mg/L and 22.95 mm/h,respectively.The mean values of C-reactive protein and erythrocyte sedimentation rate were not statistically significant for the differentiation of Crohn's disease from ulcerative colitis(P>0.05).Conclusion The CT enterography imaging features can be used to differentiate colon-type Crohn's disease from ulcerative colitis more visually.It provides a more reliable basis for treatment plan design by combining clinical,endoscopic manifestations and pathological diagnosis.