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克罗恩病的MDCT小肠造影 预览 被引量:26

MDCT Enterography of Crohn' s Disease
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摘要 目的:分析克罗恩病(CD)的CT小肠造影(CTE)特征,探讨CTE在CD诊断中的价值。方法:回顾性研究2005年6月~2008年6月在我院经临床、影像学、肠镜、手术和病理检查确诊为克罗恩病的患者66例(研究组),所有患者皆符合WHO关于CD的诊断标准;选择2007年6月~2008年6月在我院行CTE检查,临床及影像学诊断胃肠道系统无明显病变且排除恶性肿瘤、自身免疫性疾病、肝硬化、心功能衰竭、精神病以及碘过敏的患者20例作为对照组。分析每一病灶的部位、肠壁厚度、肠壁增厚模式、肠腔狭窄、肠管直径、强化特点、并发症及周围脏器受累情况,并结合MDCT重建图像作出诊断。CT值及肠壁厚度均测量2次取平均值。数据分析应用SPSS11.5统计软件进行分析。结果:克罗恩病最常见的病变部位为回肠(80.3%),最常见的影像学表现是肠壁增厚(95.5%)。CTE检查除了能显示肠壁增厚及肠腔狭窄外,还可清晰显示病变肠管周围的并发症,包括肠系膜水肿及增厚、肠系膜淋巴结增生、蜂窝织炎、腹腔脓肿、窦道和窦管形成。66.7%患者可见梳征,有梳征的患者多为A型或B型肠壁增厚(65.9%),而无梳征患者多为C型或D型肠壁增厚(78.9%)(P〈0.01),提示梳征与疾病活动度相关。结论:CT小肠造影对克罗恩病的诊断、活动性判断及并发症诊断具有独到的优越性,可作为首选的影像学检查方法,同时还应结合临床症状、肠镜检查以及传统的钡剂小肠造影以正确、完整诊断CD。 Purpose: To evaluate the role of CTE (CT enterography) in the diagnosis of Crohn's disease (CD), discuss the typical CTE performance of CD. Methods: Retrospective analysis was made on 66 patients with CD and 20 normal controls. CD group: 66 patients admitted to our hospital diagnosed as CD by clinical manifestation, examination of enteroscope or surgery and pathology during 2005.6 - 2008.6, all have unabridged CTE materials. Control group: 20 patients who underwent CTE in our hospital during 2007.6- 2008.6 with both normal clinical and imaging diagnosis and the exclusion criteria includes malignancy, connective tissue disease, liver cirrosis, heart failure, psychosis and allergic to iodine. Each CT imaging was analyed at diagnosis site including position of every focus, thickness of intestinal wall, types of intestinal wall thickening, stenosis of enteric cavity, CT attenuations of intestinal wall, complications and adjacent organs involvement. Diagnosis was finally given with the combination of MSCT reconstruction images. CT attenuations and thickness of intestinal wall were measured twice and got the average. Statistical processing was made by using software package SPSS for Windows release 11.5. Results: Ileum is most frequently involved in CD (80.3%). Small bowel wall thickening( 〉 4mm)is the most common sign of CTE. CTE can not only give high resolution image of small bowel wall, thickening and stenosis of enteric cavity, but also complications such as mesenteric edema, mesenteric thickening, mesenteric lymph nodes hyperplasia, phlegmon, peritoneal abscess, sinus and fistulae. Comb like pattern was detected in 66.7% CD patients. The patients with comb like pattern were most type A or type B small bowel thickening, but the patients without comb like pattern were most type C or type D small bowel thickening. This result suggested that comb like pattern had significantly correlated with CD activity. Conclusions: CTE proved to have advantages in diagnosis, evaluating the activity
作者 吴颖为 唐永华 郝楠馨 林翌 顾培祥 缪飞 WU Ying- wei, TANG Yong- hua, HAO Nan- xin, LIN Yi , GU Pei- xian, MIAO Fei(1 Department of Radiology, Ruijin Hospital,Shanghai Jiaotong University 2 Department of Radiology, Dongfang HospitaI,Tongji University)
出处 《中国医学计算机成像杂志》 CSCD 北大核心 2009年第1期 57-63,共7页 Chinese Computed Medical Imaging
基金 上海市卫生局课题(05-III-005-026)
关键词 克罗恩病 CT小肠造影 Crohn's disease CT enterography
作者简介 通信作者:缪飞(电子邮箱:miaofei818@yahoo.com.cn)
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