摘要
目的分析Crohn病的多层螺旋CT小肠造影（multislice computer tomography enterography,MSCTE）影像征象,并讨论其对该病的诊断价值。方法回顾性分析28例经内镜、手术、病理证实的Crohn病的MSCTE影像学资料,全部患者行CT平扫和动脉期、静脉期增强扫描,并行MPR、厚层MIP等重建。结果 28例中单纯小肠受累（9/28）,小肠-结肠同时受累（16/28）,单独结肠受累（3/28）,病变以累及回肠末端最为常见（20/28）。MSCTE表现：肠壁增厚（28/28）,肠壁厚度4.5～23.2mm;增强扫描肠壁分层状强化（19/28）,均匀强化（9/28）,肠腔狭窄（15/28）,肠系膜淋巴结增大（19/28）,病变肠管周围肠系膜血管增多（15/28）;MSCTE表现肠壁增厚、分层状强化、肠系膜脂肪渗出性改变、血管增多（梳征）等征象可提示克罗恩病（CD）病变处于活动期。结论 MSCTE是一种诊断Crohn病较敏感的非侵入性成像方法,可同时显示肠壁及肠腔外病变,且对CD的活动性评估具有一定优势,可作为该病首选的影像诊断方法。
Objective To analyse the MSCTE imaging fingdings and to discuss the diagnostic value of Crohn＇s disease.Methods 28 patients with histologically proven Crohn＇s disease underwent MSCTE.Imaging findings were analyzed retrospectively.All patients underwent CT enterography examination,The multi-planar reformation（MPR）,maximum intensity projection（MIP）images were generated from raw data.Results Among the 28 cases,9cases had lesions limited to the small intestine,the small int estine and the colon were involved simultaneously in 16 cases,only 3cases had lesions limited to the colon.Terminalileum is most frequently involved in CD（20/28）,MSCTE showed there were 28 cases of bowel wall thickening,wich wall thickness of 4.5～23.2mm,19 cases of enhanced scanning strengthen the intestinal wall layering,9cases of uniform reinforcement,15 cases of stenosis,19 cases of mesenter ic lymphadenopathy,15 cases of increased intestinal lesions surrounding mesenteric vessels.Bowel wall thickening,hierarchical reinforcement,mesenteric fat exudative change,increase in blood vessels（comb sign）may indicate CD pathological changes in the activity.ConclusionMSCTE is a more sensitive in the diagnosis of Crohn＇s disease noninvasive imaging method,It can also show the intestinal wall and gut lesions,and be used as the preferred imaging in the diagnosis of the disease.
出处
《医学影像学杂志》
2015年第3期466-469,共4页
Journal of Medical Imaging
基金
宁波大学校级科研项目(XYY12032)
