摘要
目的:总结与评估多排CT小肠造影(CT enteroclysis,CTE)在克罗恩病(Crohn's disease,CD)临床诊断与病情评估中的应用价值.方法:回顾性分析31例CD患者的病史资料,分析与总结CD患者CTE的影像学特点,并与炎症活动生物指标[血沉(erythrocyte sedimentation rate,ESR)、C-反应蛋白(C-reactive protein,CRP)]、结肠镜、单气囊小肠镜等结果进行比较分析.结果:CTE诊断阳性率在活动期CD为75%,缓解期为66.7%.CD活动期CTE常见的表现为节段性肠壁增厚(26例,92.9%)、双层或多层强化(20例,71.4%)、肠周围淋巴结肿大(20例,71.4%)、肠系膜血管增多/梳状征(17例,60.7%)、肠腔狭窄(13例,46.4%),随着疾病活动程度加重,此5种CTE表现的阳性率有逐渐升高趋势,且均与CRP呈正相关,而多层强化、梳状征与ESR水平具有正相关.25例CD患者行结肠镜检查,11例(44.0%)结肠镜与CTE发现病变部位一致,10例(40.0%)结肠镜下未见末端回肠病变而CTE下可见小肠病变,结肠镜与CTE二者联合诊断23例(92.0%).31例中有12例行单气囊小肠镜检查,结果显示所有12例(100%)CD患者CTE发现的病变部位均与单气囊小肠镜一致.结论:常规结肠镜检查联合CTE可有效而全面的评估CD患者的病情,尤其对于小肠病变的发现以及疾病的活动性评估等方面,CTE有重要价值.
AIM： To evaluate the value of CT enteroclysis （CTE） in the diagnosis and assessment of Crohn’s disease（CD）. METHODS： The clinical and imaging data for 31 patients with CD were retrospectively analyzed. CTE imaging features were compared with erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP）, and results of colonoscopy and single balloon enteroscopy （SBE）. RESULTS： The rate of detection of CD by CTE was 75% in patients with active CD and 66.7% in patients with disease in remission. Imaging findings included intestinal wall thickening in 26 cases （92.9%）, mural stratification enhancement in 20 cases （71.4%）, lymph node swelling in 20 cases （71.4%）, comb sign in 17 cases （60.7%）, and intestinal stenosis in 13 cases （46.4%）. The detect rate was correlated with disease activity and CRP, and mural stratification enhancement and comb sign were correlated with ESR. CTE features were consistent with colonoscopy results in 11 cases （44.0%）; however, 10 cases （40.0%） tested positive by CTE but negative by colonoscopy in founding small bowel lesions. The combined detection rate for CTE and colonoscopy was 92.0%. Twelve patients underwent SBE, and the SBE findings on the location of lesions were completely consistent with those of CTE in all 12 cases. CONCLUSION： Colonoscopy and CTE can be used to effectively and comprehensively assess CD condition, and CTE is helpful in detection of small intestinal lesions and evaluation of disease activities.
出处
《世界华人消化杂志》
CAS
北大核心
2013年第3期220-225,共6页
World Chinese Journal of Digestology
关键词
CT小肠造影
克罗恩病
单气囊小肠镜
结肠镜
C反应蛋白
CT enteroclysis
Crohn’s disease
Single balloon enteroscopy
Colonoscopy
C-reactive protein
