中国医学科学院学报ACTAACADEMIAEMEDICINAESINICAE498August,2009·论著·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2,吴晰1,温小恒1,秦明伟2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通信作者:秦明伟电子邮件:qinmingwei@hotmail1com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(5313%),小肠造影发现9例(30%),二者比较差异具有显著性(P=01039);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(9617%)和18例(60%),二者比较差异具有显著性(P=01001),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(5313%vs14313%,P=01375),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;克罗恩病中图分类号:R574文献标识码:A文章编号:10002503X(2009)0420498205DOI:1013881/j1issn110002503X120091041023DiagnosticValueofCTEnterographyinPatientswithCrohnπsDiseaseSHIJi2hua1,LIUWei2,LUXing2hua1,PANWei2dong2,WANGYun2,WUXi1,WENXiao2heng1,QINMing2wei21DepartmentofGastroenterology,2DepartmentofRadiology,PUMCHospital,CAMSandPUMC,Beijing100730,ChinaCorrespondingauthor:QINMing2weiE2mail:qinmingwei@hotmail1comABSTRACT:ObjectiveToassessthediagnosticvalueofCTenterographyinpatientswithCrohnπsdis2ease1MethodsMulti2detectorCTenterographyandsmallbowelfollow2throughwereperformedin30patientswithCrohnπsdisease1Thelocationsandcharacteristicsoftheintestinalandextra2intestinallesionsdetectedbybothtwotechniqueswerecompared1ResultsSkiplesionswerediagnosedin16patients(5313%)byCTen2terographyandin9patients(30%)bysmallbowelfollow2through(P=01039)1Mucosalchangeswerede2tectedin29patients(9617%)byCTenterographyandin18patients(60%)bysmallbowelfollow2through(P=01001)1Among11patientswhosesmallbowelfollow2throughdidnotshowabnormalmucosalchanges,8patientsunderwentendoscopy,whichshowedsuperficialulcerwithorwithoutmucosalcongestionandedemain5patients,mucosalcongestionandedemain2patients,andmucosalerosionin1patient1CTenterographyandsmallbowelfollow2throughconsistentlydepictedfistulain3patientsandhadnosignificantdifferenceindi2agnosingintestinalstenosis1CTenterographyalsoexclusivelydetectedabdominalabscessinonepatient1Con2clusionsCTenterographyissuperiortosmallbowelfollow2throughindiagnosingthediseaselocationandchar2acteristicsofCrohnπsdisease;furthermore,itcandetectmoreextra2intestinallesions1CTenterographyhaspo2CT小肠成像对克罗恩病的诊断价值Vol131No14499tentialtoreplacesmallbowelfollow2throughastheimagingexaminationofchoiceforpatientswithCrohnπsdis2ease1Keywords:CTenterography;smallbowelfollow2through;CrohnπsdiseaseActaAcadMedSin,2009,31(4):498-502克罗恩病是可以累及全消化道的慢性炎症性疾病,同时还可以导致脓肿、瘘管、肠梗阻、肠穿孔等一系列并发症,诊断和治疗均存在一定困难。在小肠镜和胶囊内镜尚未被广泛应用以前,传统的钡剂小肠造影(small2bowelfollow2through,SBFT)一直是诊断克罗恩病小肠病变的金标准,但是它无法清晰、完整的显示病变的情况,并且存在一些禁忌证。近几年兴起的CT小肠成像(CTenterography,CTE)技术是...
