克罗恩病与肠结核的CT表现特征鉴别分析

发布时间：2018-03-19 03:25

本文选题：Crohn病　切入点：肠结核　出处：《南京医科大学学报(自然科学版)》2017年12期 　论文类型：期刊论文

【摘要】：目的 :研究克罗恩病(Crohn’s disease,CD)与肠结核(intestinal tuberculosis,ITB)的CT表现,为两者的鉴别诊断提供依据。方法:回顾性分析经临床确诊的109例CD和43例ITB的CT资料,采用卡方检验、t检验比较CD和ITB患者的CT征象间定性及定量结果的差异。结果:CD多累及回肠,呈多节段分布,病变肠壁表现为不对称性增厚,病变肠管的肠系膜对侧可表现为假憩室,淋巴结多表现为均匀强化,肠系膜血管增生,纤维脂肪增生,并发瘘管;ITB好发于回盲部,病变肠管表现为对称性增厚,淋巴结可表现为钙化及中心坏死,腹膜可发生增厚及腹水。肠壁的不对称性增厚、假性憩室及瘘管对CD的诊断敏感性、特异性分别为34.9%/100.0%,26.6%/100.0%及13.8%/100.0%;淋巴结钙化、坏死及腹膜增厚对ITB诊断的敏感性、特异性分别为9.3%/100.0%、7.0%/100.0%及18.6%/100.0%。结论 :CTE能显示肠壁,肠周及并发症等情况,有助于CD和ITB的鉴别。
[Abstract]:Objective: to study the CT findings of Crohn's disease (CD) and intestinal tuberculosis (ITB) in order to provide basis for differential diagnosis. Methods: Ct findings of 109 cases of CD and 43 cases of ITB were retrospectively analyzed. The qualitative and quantitative results of CT findings of CD and ITB patients were compared by chi-square test. The contralateral mesentery of the diseased intestine may be presented as pseudo-diverticulum, and the lymph nodes usually show homogeneous enhancement, mesenteric vessel hyperplasia, fibrous fat hyperplasia, complicated with fistula ITB in the ileocecal region, and symmetrical thickening of the diseased intestinal canal. Lymph nodes can show calcification and central necrosis, peritoneum thickening and ascites. Asymmetry thickening of intestinal wall, sensitivity of pseudo-diverticulum and fistula to CD diagnosis, specificity is 34.9R / 100.026.6R / 100.0% and 13.8R / 100.0%, respectively; lymph node calcification, The sensitivity of necrosis and peritoneal thickening to the diagnosis of ITB was 9.3 / 100.00.The specificity was 7.0% and 18.6% 100.0.Conclusion ITB can show the intestinal wall, periintestinal complications and complications, which is helpful for the differential diagnosis of CD and ITB.
【作者单位】：南京医科大学第一附属医院放射科;
【基金】：江苏高校优势学科建设工程基金(JX10231801)
【分类号】：R524;R574;R816.5

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