多层螺旋CT小肠造影在炎症性肠病诊断中的应用价值

Application value of multi-slice spiral CT enterography in the diagnosis of inflammatory bowel disease

目的探讨多层螺旋CT小肠造影(CTE)在炎症性肠病(IBD)诊断中的应用价值。方法回顾性纳入2020年3月至2022年7月在陈家桥医院经病理确诊的IBD患者,总结分析临床病史、CTE影像学特征,计算CTE诊断IBD的敏感度、特异度。结果共纳入60例IBD患者,溃疡性结肠炎(UC)患者35例,克罗恩病(CD)患者25例,二者的临床特征差异无统计学意义(P>0.05)。CTE检出UC的敏感度89%、特异度84%;CTE检出CD的敏感度88%、特异度91%。CD以回肠末端与回盲部多见。UC以对称性增厚为主,CD以非对称性增厚为主,且CD较UC更易出现梳征、蜂窝组织炎及瘘管(P<0.05);CD与UC均出现均匀或非均匀强化,差异无统计学意义(P>0.05)。结论CTE清晰显示肠壁、肠腔外病变,有助于UC和CD的鉴别诊断,是IBD诊断有效检查手段。

Objective To explore the value of multi-slice spiral CT enterography(CTE)in the diagnosis of inflammatory bowel disease(IBD).Methods Patients with pathologically confirmed IBD at Chenjiaqiao Hospital from March 2020 to July 2022 were retrospectively included to summarize and analyze the clinical history,CTE imaging features,and calculate the sensitivity and specificity of CTE in diagnosing IBD.Results Totally 60 patients with IBD were included,including 35 patients with ulcerative colitis(UC)and 25 patients with Crohn′s disease(CD),the clinical features of which were not statistically significant(P>0.05).88.6%sensitivity and 84.0%specificity of CTE for detecting UC and 88.0%sensitivity and 91.4%specificity of CTE for detecting CD.CD is more common in the distal ileum and ileocecal region.Symmetric thickening is predominant in UC and asymmetric thickening in CD,and CD is more likely to show comb signs,cellulitis and fistulae than UC(P<0.05);both CD and UC showed homogeneous or non-homogeneous enhancement,with no statistically significant difference(P>0.05).Conclusion CTE clearly displays intestinal wall and extraluminal lesions,which is helpful for the differential diagnosis of UC and CD,and is an effective test for the diagnosis of IBD.