大小肠双充盈法多层螺旋CT肠道成像对炎症性肠病的诊断价值

发布时间：2018-03-06 21:10

本文选题：炎性肠疾病　切入点：体层摄影术　出处：《中国医学影像学杂志》2015年01期 　论文类型：期刊论文

【摘要】：目的总结炎症性肠病(IBD)在大小肠双充盈法多层螺旋CT(MSCT)肠道成像中的影像表现,评价该成像方法对IBD的诊断价值。资料与方法回顾性分析42例克罗恩病(CD)和10例溃疡性结肠炎(UC)患者的CT资料,均采用大小肠双充盈法MSCT肠道成像,评价肠管扩张程度和病变显示情况。结果 52例患者中,回肠扩张最佳10例(19.23%),扩张良好42例(80.77%);空肠扩张良好21例(40.38%),扩张欠佳31例(59.62%);大肠评价范围全面50例(96.15%),回盲部显示良好52例(100.00%)。42例CD患者中,仅小肠受累20例(47.62%),大小肠同时受累22例(52.38%)。9例UC仅累及结肠,1例累及全结肠及末端回肠。52例患者的MSCT表现显示明确,其中肠壁增厚及异常强化52例;肠腔狭窄28例,肠系膜血管增多46例,肠系膜淋巴结肿大27例,肠管周围蜂窝织炎10例,不全小肠梗阻4例,脓肿或炎性肿块7例,腹腔内瘘3例,肛周病变12例;浆膜腔积液15例,骶髂关节炎13例,泌尿系及胆系结石18例,肝脾肿大9例。结论大小肠双充盈法MSCT肠道成像不但能较好地同时显示小肠和大肠自身的肠壁病变,而且能明确显示肠外病变及并发症,可以明显提高IBD病变的定位及定性准确率。
[Abstract]:Objective to summarize the imaging findings of inflammatory bowel disease (IBD) in large intestine with double filling multi-slice spiral CT MSCT (MSCT). Data and methods CT findings of 42 patients with Crohn's disease and 10 patients with ulcerative colitis were analyzed retrospectively. The large intestine double filling MSCT enterography was used. Results in 52 patients, the degree of intestinal dilatation and the manifestation of intestinal lesions were evaluated. The best ileum dilatation was 19.23, good dilatation was found in 42 cases, jejunum dilated well in 21 cases (40.38) and poor dilatation in 31 cases (59.62%). The range of evaluation of large intestine in 50 cases was 96.15%, and in ileocecal part 52 cases were 100.00.42 cases of CD. The MSCT findings of 20 cases of small intestine involvement and 22 cases of large intestine involvement at the same time were 52.38%. The MSCT findings of 9 cases of UC involving only 1 case of total colon and terminal ileum were clear, including 52 cases of intestinal wall thickening and abnormal enhancement, 28 cases of lumen stenosis, 28 cases of intestinal lumen stenosis, 2 cases of small intestine involvement and 22 cases of large intestine involvement at the same time. There were 46 cases of mesenteric angiogenesis, 27 cases of mesenteric lymphadenopathy, 10 cases of peri-intestinal cellulitis, 4 cases of incomplete intestinal obstruction, 7 cases of abscess or inflammatory mass, 3 cases of abdominal fistula, 12 cases of perianal lesions, 15 cases of serous cavity effusion. There were 13 cases of sacroiliac arthritis, 18 cases of urinary and biliary calculi, 9 cases of hepatosplenomegaly. Conclusion double filling MSCT can not only show the intestinal wall lesions of small intestine and large intestine at the same time. In addition, it can clearly show parenteral lesions and complications, and can improve the accuracy of localization and qualitative analysis of IBD lesions.
【作者单位】：温州市龙湾区第一人民医院放射科;温州市龙湾区第一人民医院重症医学科;温州市龙湾区第一人民医院检验科;上海交通大学医学院附属仁济医院放射科;
【分类号】：R816.5;R574

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