64排螺旋CT诊断小肠Crohn病16例

目的探讨64层螺旋cT及后处理技术对小肠Crohn病的诊断价值，以提高对本病的认识和诊断水平。方法回顾分析经肠镜、手术、病理证实的16例小肠Crohn病病例，全部病例均行64层螺旋CT平扫，9例行三期增强扫描，并用ADW4．4后处理工作站进行多平面重建（MPR）、最大密度投影（MIP）及容积成像（VR）重建成像。结果16例中，表现为肠壁增厚47个节段，28个节段均匀强化，12个节段分层强化；7个节段强化不明显。肠腔狭窄20节段，12例系膜缘肠壁增厚大于对侧。肠系膜血管增多、增粗及“梳样征”17个节段，肠系膜淋巴结肿大8例，肠管周围蜂窝织炎6例，瘘管形成4例，腹腔脓肿6例，炎性包块4例，消化道穿孔2例。MPR、MIP技术有助于对病变的全面显示。结论小肠Crohn病的影像学表现有其特征件．能为临床诊断及治疗槔供依根．

Analysis of 64 spiral CT in diagnosis of Crohn disease

Objective To investigate the value of 64 slice spiral CT and postprocessing techniques in diagnosis of small intestinal Crohn disease, in order to improve theunderstanding and diagnostic level of this disease. Methods In 16 cases withCrohn disease of the small bowel enteroscopy, operation and pathology, were analyzed retrospectively, all cases underwent 64 slice spiral CT scan, 9 cases ofthree phase enhanced scanning, and multi planar reconstruction in ADWd. 4 workstation （MPR）, maximum intensity projection （MIP） and volume imaging （VR） reconstruction imaging. Results of the 16 cases showed thickening of the intestinal wall, 47 segments, 28 segments homogeneous enhancement, 12 segments in hierarchical reinforcement, the 7 section was not obviously enhanced. The intestinal lumen stenosis in 20 segments, 12 cases of bowel wall thickening, mesangial margin than on the side. Mesenteric vessels increased, thickening and ＂comb sign＂ 17 segments, 8 cases with enlarged mesenteric lymph nodes, 6 cases of intestinal surrounding cellulitis, 4 cases of fistula, 6cases of abdominal abscess, inflammatory mass in 4 cases, 2 cases of digestive tract perforation. MPR, MIP technology can be fully displayed in the lesions. Conclusion Crohn disease of the small bowel imaging has its characteristic, can provide the basis for clinical diagnosisand treatment.