中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2009, Vol. 31 ›› Issue (4): 498-502.doi: 10.3881/j.issn.1000-503X.2009.04.023

• 论著 • 上一篇    下一篇

CT小肠成像对克罗恩病的诊断价值

史济华1;刘炜2;陆星华1;潘卫东2;王沄2;吴晰1;温小恒1;秦明伟2   

  1. 中国医学科学院北京协和医学院北京协和医院 1消化内科 2放射科,北京 100730
  • 收稿日期:2009-01-12 修回日期:1900-01-01 出版日期:2009-08-30 发布日期:2009-08-30
  • 通讯作者: 秦明伟

Diagnostic Value of CT Enterography in Patients with Crohn’s Disease

SHI Ji-hua1; LIU Wei2; LU Xing-hua1;PAN Wei-dong2;WANG Yun2; WU Xi1; WEN Xiao-heng1; QIN Ming-wei2   

  1. 1Department of Gastroenterology,2Department of Radiology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China
  • Received:2009-01-12 Revised:1900-01-01 Online:2009-08-30 Published:2009-08-30
  • Contact: QIN Ming-wei

摘要: 摘要:目的 将多层螺旋CT小肠成像与传统的小肠造影进行对比,了解CT小肠成像对克罗恩病的诊断价值。方法 对已明确诊断的30例克罗恩病患者分别进行64层螺旋CT小肠成像和小肠造影检查,将两种检查方法诊断的肠道和肠外病变的部位、性质进行对比。结果 30例患者中CT小肠成像发现跳跃性病变16例(53.3%),小肠造影发现9例(30%),二者比较差异具有显著性(P=0.039);对于肠道黏膜病变,CT小肠成像和小肠造影分别诊断了29例(96.7%)和18例(60%),二者比较差异具有显著性(P =0.001),小肠造影未见黏膜异常的11例患者中8例行内镜检查,内镜发现浅溃疡伴或不伴黏膜充血水肿5例,单纯的黏膜充血水肿2例,黏膜糜烂1例。CT小肠成像和小肠造影在肠管狭窄的诊断方面差异无显著性(53.3% vs.43.3%,P =0.375),对瘘管的诊断结果一致(3例),CT小肠成像诊断腹腔脓肿1例。结论 CT小肠成像对克罗恩病病变部位和性质的诊断比小肠造影更具有优势,同时能诊断更多的肠外病变。CT小肠成像将有可能取代小肠造影成为克罗恩病主要的影像学检查方法。

关键词: CT小肠成像, 小肠造影, 克罗恩病

Abstract: ABSTRACT:Objective To assess the diagnostic value of CT enterography in patients with Crohn’s disease. Methods Multi-detector CT enterography and small bowel follow-through were performed in 30 patients with Crohn’s disease. The locations and characteristics of the intestinal and extra-intestinal lesions detected by both two techniques were compared. Results Skip lesions were diagnosed in 16 patients (53.3%) by CT enterography and in 9 patients (30%) by small bowel follow-through (P =0.039). Mucosal changes were detected in 29 patients (96.7%) by CT enterography and in 18 patients (60%) by small bowel follow-through (P =0.001). Among 11 patients whose small bowel follow-through did not show abnormal mucosal changes, 8 patients underwent endoscopy, which showed superficial ulcer with or without mucosal congestion and edema in 5 patients, mucosal congestion and edema in 2 patients, and mucosal erosion in 1 patient. CT enterography and small bowel follow-through consistently depicted fistula in 3 patients and had no significant difference in diagnosing intestinal stenosis. CT enterography also exclusively detected abdominal abscess in one patient. Conclusions CT enterography is superior to small bowel follow-through in diagnosing the disease location and characteristics of Crohn’s disease; furthermore, it can detect more extra-intestinal lesions. CT enterography has potential to replace small bowel follow-through as the imaging examination of choice for patients with Crohn’s disease.

Key words: ct enterocrapdy, small bowel follow-tdroucd, crodn’s disease