小肠Crohns病双对比影像表现的多样性

Variety images in Crohns diseases of the small bowel on double-contrast examination

目的 探讨小肠Crohns病在气钡双对比造影中的多种影像表现 ,提高对本病双对比影像的认识和诊断水平。方法 采用辅以高、低张药物 ,口服稀硫酸钡混旋剂加经肛门逆行注入空气的方法来显示小肠双对比影像 ,对病理证实的 16例小肠Crohns病双对比影像表现分别从 11个方面进行观察分析。结果 16例病例 ,全小肠都有侵犯 1例 (6.2 5 % ) ,空、回肠均有 5例(3 1.2 5 % ) ,只侵犯空、回肠交界段 3例 (18.75 % ) ,单独侵犯回肠或回肠末段 7例 (43 .75 % )。多样双对比影像表现 :①肠壁或黏膜增厚 12例 (75 % ) ;②偏心性扩张 11例 (68.75 % ) ;③跳跃征 7例 (43 .75 % ) ;④弓状扩张改变 6例 (3 7.5 % ) ;⑤局限性狭窄 6例(3 7.5 % ) ;⑥假憩室 6例 (3 7.5 % ) ;⑦小溃疡 5例 (3 1.2 5 % ) ;⑧黏膜纠集 5例 (3 1.2 5 % ) ;⑨卵石征 3例 (18.75 % ) ;⑩穿孔 2例(12 .5 % ) “多足虫”样征 1例 (6.2 5 % )。结论 ①小肠Crohns病的双对比影像有多种影像表现 ,这些表现与小肠Crohns病的各个病理阶段密切相关。②小肠Crohns病双对比影像以小肠弓状扩张、假憩室、卵石征、“多足虫”征、跳跃征、小溃疡为特征性表现 ,具有诊断意义。③“多足虫”征影像为作者提出的典型征像 ,提示小肠Crohns病的病史长 ,病变范围?

AIM To investigate the variety images in CD(Crohns Disease)of the small bowel on double contrast examination and improve diagnosis. METHODS With Meloclopramide dihydrochloride and Raceanisodamine hydrochloride medicine, drank 80%(W/V) barium liquid 200 ml and air insufflated into the rectum method to perform small intestine double contrast images. Read and analyzed feature from 11 appearances of the small intestine double contrast images in 16 patients with histopathologically verified CD. RESULTS in sixteen cases, only one patient had CD in the duodenum, jejunum and ileum at the same time(6 25%), 5 in jejunum and ileum(31 25%), 3 in distal jejunum and proximal ileum(18 75%), 7 in ileum or terminal ileum(43.75%).Double contrast image findings included ①thickened mucosal fold and intestine wall in 12(75%),② partial dilatation of the bowel lumen 11(68.75%),③ bound sign in 7(43.75%),④ arch dilatation of the bowel as the 'lead pipe' in 6(37.5%),⑤ limit stricture of bowel in 6(37.5%), ⑥ small bowel pseudodiverticulum in 6(37.5%),⑦ulcers in 5(31.25%),⑧ mucosal erosions and contract in 5(31.25%), ⑨ cobblestone mucosal pattern in 3(18.75%), ⑩ two patients had a fistula(12.5%),B11'multiple feet insect' sign in 1(6.25%).CONCLUSION ①The CD of the small bowel on Double contrast have variety images that based on pathology at the every period. ②arch dilatation of the bowel as the 'lead pipe', small bowel pseudodiverticulum, cobblestone mucosal pattern, 'multiple feet insect' sign, bound sign and elongated ulcer is the key points for diagnosis in small bowel CD patients. (3) 'multiple feet insect' sign is a new sign. Indicating the small bowel CD have a long time ,encroach widely and at the activity times.