CT小肠造影有助于评估克罗恩病患者病情严重程度

CT enterography is beneficial to evaluate disease severity in patients with Crohn's disease

目的探讨克罗恩病(CD)患者CT小肠造影(CTE)特征及对病情的评估价值。方法回顾性选取2020年1月~2024年4月本院收治的CD患者82例,根据CD活动指数(CDAI)将患者分为缓解期组(n=34,CDAI<150分)、活动期组(n=48,CDAI≥150分),两组均行CTE检查,对比两组CTE影像特征,采用ROC曲线分析CTE影像特征对CD患者病情的评估价值。结果缓解期组与活动期组患者在强化方式、肠系膜淋巴结增大、肠系膜脂肪密度增大、齿梳征和蜂窝组织炎等特征的差异有统计学意义(P<0.05);缓解期组患者肠壁厚度、动脉期CT值及静脉期CT值均低于活动期组(P<0.05);ROC结果显示,肠壁厚度、动脉期CT值、静脉期CT值及其联合检测(并联)评估CD患者病情严重程度的曲线下面积分别为0.857、0.775、0.808、0.920(P<0.05)。结论CTE可全面清晰显示CD患者肠壁及肠外表现,且其定量参数肠壁厚度、动脉期CT值及静脉期CT值有助于评估CD患者病情严重程度。

Objective To explore the characteristics of CT enterography(CTE)and their evaluation value for disease severity in patients with Crohn's disease(CD).Methods A total of 82 patients with CD admitted to the hospital were retrospectively enrolled from January 2020 to April 2024.According to CD activity index(CDAI),they were divided into remission group(n=34,CDAI<150 points)and active group(n=48,CDAI≥150 points).All patients underwent CTE.CTE characteristics were compared between the two groups.The evaluation value of CTE characteristics for disease severity in CD patients was analyzed by ROC curves.Results There were differences in enhancement mode,enlargement of mesenteric lymph nodes,increase of mesenteric fat density,tooth comb sign and cellulitis between the two groups(P<0.05).The thickness of intestinal walls,CT values in arterial and venous phases in remission group were lower than those in active group(P<0.05).The results of ROC curves analysis showed that area under the curve values of intestinal wall thickness,arterial CT value,venous CT value and combined detection(parallel mode)for evaluating disease severity in CD patients were 0.857,0.775,0.808 and 0.920,respectively(P<0.05).Conclusion CTE can fully and clearly display intestinal wall and parenteral manifestations in CD patients.CTE quantitative parameters(thickness of intestinal walls,CT values in arterial and venous phases)are beneficial to evaluate disease severity in CD patients.