多层螺旋CT小肠造影对克罗恩病的诊断分析

目的 探讨多层螺旋CT小肠造影对胃肠道克罗恩病（CD）的诊断价值.方法 回顾性分析16例确诊CD患者的全腹部MSCT平扫及双期增强检查的CT表现,并以20例肠道无异常的受检者作对照.检查前清洁肠道,肌注654-2液10-20mg,分时段口服大剂量2.5%等渗甘露醇溶液充分充盈肠管,结合多平面重建（MPR）和最大密度投影（MIP）观察.结果 16例CD（病例组）2.13例经结肠镜及病理结果确诊,3例经临床确诊.在16例CD中,CT上均出现病变段肠壁异常强化及病灶节段性分布特点,肠壁增厚15例,黏膜溃疡6例,黏膜鹅卵石征3例,假憩室征2例;肠系膜病变＂梳状征＂9例,肠系膜淋巴结增生4例;瘘管1例;肿块2例,不全性梗阻2例.结论 多层螺旋CT小肠造影双期增强扫描结合重建技术对胃肠道CD,尤其是小肠CD的诊断、病变分期的判断和临床疗效的评价方面有重要的临床应用价值.

Value of multi-slice CT enterography for diagnosing Crohn's disease

Objective To study the diagnostic value of muhi-slice CT enterography （ MSCTE ） in patients with Crohn＇s disease （CD）. Methods Unenhanced and dual-phase contrast-enhanced MSCT of abdomen in 16 patients with CD confirmed by colonoscopy （13） and clinical follow-up （3） were retrospectively analyzed using 20 cases without intestinal diseases as normal control. The axial CT images were acquired after bowel cleansing, 10-20 mg of intramuscular injection of 654-2 to minimize peristalsis and small bowel distention with 2.5% iso-osmotic mannitol. Multi-planar reconstruction （MPR） and maximum intensity projection （MIP） were performed for image analysis. Results CT showed abnormal en- hancement of bowel wall in segmental distribution （16）, bowel wall thickening （15）, mucosal ulceration （6）, nodular mucosa （3）, false diverticula （2）, mesenteric stranding （9）, mesenteric lymph node hyperplasia （4）, small bowel fistula （1）, mass （2）, and partial bowel obstruction （2）. Conclu- sion Dual-phase contrast-enhanced MSCTE with MPR and MIP reconstruction techniques is valuable in the diagnosis and staging of small intestinal CD.