The Value of Multi-slice Spiral CT Enterography in Diagnosing Crohn’ s Disease_West China Medical Journal

Authors：

YANG Chun ¹ , YAO Qiandong ¹ ,  ZHENG Minwen. ²

1. Department of Radiology, Sichuan Science City Hospital, Mianyang, Sichuan 621900, P. R. China; 2. Department of Radiology, Xijing Hospital, the Fourth Military Medical University, Xi’an, Shaanxi 710032, P. R. China;

Corresponding author：

ZHENG Minwen., Email: scc_yang@sina.com

Keywords：

肠疾病; Crohn病; 体层摄影术，X线计算机

DOI：

10.7507/1002-0179.20130018

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目的　探讨多层螺旋CT（MSCT）在肠道Crohn病（CD）诊断中的应用价值。方法　回顾性分析2009年2月－2012年2月经综合方法确诊为CD的41例患者的MSCT表现，分析病变肠管的部位、肠壁的厚度和增强后病变肠壁的强化程度及并发症。结果　41例中，患病肠段多节段性受累36例（87.8%），单独小肠受累16例（39.0%），小肠和结肠同时受累23例（56.2%），单独结肠受累2例（4.8%），回肠末段受累36例（87.8%），盲肠或升结肠受累22例（53.7%）。41例肠壁均见不同程度的强化及环形增厚；28例（68.3%）表现肠壁分层；23例（56.1%）表现为系膜纤维脂肪增生、蜂窝织炎，16例（39.0%）系膜血管增多，呈“梳样征”，20例（48.8%）伴有系膜及腹膜后淋巴结肿大；6例（14.6%）并发不全肠梗阻，并发瘘管穿孔1例（2.4%）。结论　MSCT可同时显示CD的小肠和结肠病变，对肠壁病变及肠腔外并发症的显示以及在判断病变活动性方面有独特的优越性，对指导临床治疗具有重要意义。

Citation： YANG Chun,YAO Qiandong,ZHENG Minwen.. The Value of Multi-slice Spiral CT Enterography in Diagnosing Crohn’ s Disease. West China Medical Journal, 2013, 28(1): 63-67. doi: 10.7507/1002-0179.20130018 Copy

1.	朱庆强, 朱文荣, 王中秋, 等. X线、CT和消化内镜对克罗恩病诊断价值的评价[J]. 实用放射学杂志, 2011, 27(5): 729-733.
2.	陆星华, 秦明伟, 温小恒, 等. 胶囊内镜、CT小肠成像、小肠造影及回结肠镜对克罗恩病诊断价值的比较[J]. 中华内科杂志, 2010, 49(9): 746-749.
3.	鲁桂青, 刘林祥, 陈克敏, 等. 多层螺旋CT在小肠Crohn病中的应用研究[J]. 中华放射学杂志, 2009, 43(4): 373-377.
4.	Solem CA, Loftus EV Jr, Fletcher JG, et al. Small-bowel imaging in Crohn’s disease: a prospective, blinded, 4-way comparison trial[J]. Gastrointest Endosc, 2008, 68(2): 255-266.
5.	Lee SS, Kim AY, Yang SK, et al. Crohn disease of the small bowel: comparison of CT enterography, Mr enterography, and small-bowel follow-through as diagnostic techniques[J]. Radiology, 2009, 251(3): 751-761.
6.	Baker ME, Walter J, Obuchowski NA, et al. Mural attenuation in normal small bowel and active inflammatory Crohn’s disease on CT enterography: location, absolute attenuation, relative attenuation, and the effect of wall thickness[J]. AJR Am J Roentgenol, 2009, 192(2): 417-423.
7.	史济华, 刘炜, 陆星华, 等. CT小肠成像对克罗恩病的诊断价值[J]. 中国医学科学院学报, 2009, 31(4): 498-502.
8.	Higgins PD, Caoili E, Zimmermann M, et al. Computed tomographic enterography adds information to clinical management in small bowel Crohn’s disease[J]. Inflamm Bowel Dis, 2007, 13(3): 262-268.
9.	Vogel J, da Luz Moreira A, Baker M, et al. CT enterography for Crohn’s disease: accurate preoperative diagnostic imaging[J]. Dis Colon Rectum, 2007, 50(11): 1761-1769.
10.	Soyer P, Boudiaf M, Sirol M, et al. Suspected anastomotic recurrence of Crohn disease after ileocolic resection: evaluation with CT enteroclysis[J]. Radiology, 2010, 254(3): 755-764.
11.	Hara AK, Alam S, Heigh RI, et al. Using CT enterography to monitor Crohn’s disease activity: a preliminary study[J]. AJR Am J Roentgenol, 2008, 190(6): 1512-1516.
12.	赵亚娥, 汪登斌, 韩本谊, 等. 克罗恩病合并泌尿系结石的多层螺旋CT检查价值[J]. 放射学实践, 2011, 26(6): 631-633.

1. 　朱庆强, 朱文荣, 王中秋, 等. X线、CT和消化内镜对克罗恩病诊断价值的评价[J]. 实用放射学杂志, 2011, 27(5): 729-733.
2. 　陆星华, 秦明伟, 温小恒, 等. 胶囊内镜、CT小肠成像、小肠造影及回结肠镜对克罗恩病诊断价值的比较[J]. 中华内科杂志, 2010, 49(9): 746-749.
3. 　鲁桂青, 刘林祥, 陈克敏, 等. 多层螺旋CT在小肠Crohn病中的应用研究[J]. 中华放射学杂志, 2009, 43(4): 373-377.
4. 　Solem CA, Loftus EV Jr, Fletcher JG, et al. Small-bowel imaging in Crohn’s disease: a prospective, blinded, 4-way comparison trial[J]. Gastrointest Endosc, 2008, 68(2): 255-266.
5. 　Lee SS, Kim AY, Yang SK, et al. Crohn disease of the small bowel: comparison of CT enterography, Mr enterography, and small-bowel follow-through as diagnostic techniques[J]. Radiology, 2009, 251(3): 751-761.
6. 　Baker ME, Walter J, Obuchowski NA, et al. Mural attenuation in normal small bowel and active inflammatory Crohn’s disease on CT enterography: location, absolute attenuation, relative attenuation, and the effect of wall thickness[J]. AJR Am J Roentgenol, 2009, 192(2): 417-423.
7. 　史济华, 刘炜, 陆星华, 等. CT小肠成像对克罗恩病的诊断价值[J]. 中国医学科学院学报, 2009, 31(4): 498-502.
8. 　Higgins PD, Caoili E, Zimmermann M, et al. Computed tomographic enterography adds information to clinical management in small bowel Crohn’s disease[J]. Inflamm Bowel Dis, 2007, 13(3): 262-268.
9. 　Vogel J, da Luz Moreira A, Baker M, et al. CT enterography for Crohn’s disease: accurate preoperative diagnostic imaging[J]. Dis Colon Rectum, 2007, 50(11): 1761-1769.
10. 　Soyer P, Boudiaf M, Sirol M, et al. Suspected anastomotic recurrence of Crohn disease after ileocolic resection: evaluation with CT enteroclysis[J]. Radiology, 2010, 254(3): 755-764.
11. 　Hara AK, Alam S, Heigh RI, et al. Using CT enterography to monitor Crohn’s disease activity: a preliminary study[J]. AJR Am J Roentgenol, 2008, 190(6): 1512-1516.
12. 　赵亚娥, 汪登斌, 韩本谊, 等. 克罗恩病合并泌尿系结石的多层螺旋CT检查价值[J]. 放射学实践, 2011, 26(6): 631-633.

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The Value of Multi-slice Spiral CT Enterography in Diagnosing Crohn’ s Disease

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