摘要
目的探讨小肠CT造影在克罗恩病(Crohn’s disease,CD)临床诊断中的应用价值。方法回顾性分析24例经肠镜或手术明确诊断的克罗恩病患者的临床资料和小肠CT造影检查资料。结果本组患者临床表现包括腹痛(75%,18/24)、腹泻(70.8%,17/24)、血便或脓血便(25%,6/24)、肛瘘(50%,12/24)。小肠CT造影检查显示病变位于空肠或回肠(16例)、回肠末端及回盲部(20例)、结肠(12例)。病变处肠壁多表现为多节段性增厚,其中2例肠壁增厚呈团块样改变,增强扫描后肠壁单层强化4例(16.7%),双层或多层强化20例(83.3%),1例见强化包块。肠壁系膜侧系膜血管束增多、增粗,其中8例尚表现出"齿梳征"(33.3%,8/24)。本组16例伴有不同程度肠腔狭窄,4例并出现不全性肠梗阻,肛瘘患者12例(50%),未发现腹腔脓肿或肠穿孔。结论小肠CT造影检查可清晰显示病变肠管的改变以及肠管外并发症情况,对克罗恩病诊断具有重要价值。
Objective The purpose of this study was to explore the value of CT enteroclysis （CTE） in the diagnosis and assessment of Crohn＇ s disease （CD）. Methods The clinical and imaging data of 24 CDs confirmed by enteroscope or surgery were analyzed retrospectively, including the gender, age, clinical symptoms, lesion location, intestinal wall thickening, enhancement mode, luminal stenosis, mesenteric vascular, peripheral lymph node and several complications such as incomplete ileus, anal fistula, et al. Results In 24 patients （7 women, 17 men; mean age, 35.5 years） with known CD, the clinical manifestations included stomachache （ 75 %, 18/24）, diarrhea （70.8 %, 17/24 ）, bloody stools or bloody purulent stool （ 25 %, 6/24 ） anal fistula （50% , 12/24）. The CTE showed lesions involved in small intestine （16 cases）, ileocecal junction or terminal ileum （20 cases）, and colon （12 cases）. The intestinal wall presented multiple segmental thickening with cloddy transformation in two cases. All lesions were inordinately enhanced after the contrast agent injection, single stratification enhancement in 4 cases （ 16.7% ）, mural stratification enhancement in 20 cases （83.3%） , and one case showed enhanced mass. The mesenteric vascular increased and roughened, and typical ＂comb sign＂ was observed in 8 cases. Luminal stenosis, incomplete ileus, anal fistula was found in 16, 4 and 12 cases, respectively. There＇ s no intraperitoneal abscess and enterobrosis in all cases. Conclusion CTE can clearly showed the intestinal wall and is extra-intestinal complication of CD, and proved to be valuable in diagnosis of CD. The typical imaging findings of CD in CT include multiple segmental intestinal wall thickening and enhanced, mesenteric vascular increased and roughened with typical ＂comb sign＂, perienteric lymph node reactive proliferation. Some patients may have several complications such as intestinal stenosis and secondary obstruction anal fistula.
出处
《医学影像学杂志》
2016年第10期1821-1824,共4页
Journal of Medical Imaging
