多层螺旋CT小肠造影评估克罗恩病活动度的临床价值

发布时间：2018-01-30 16:00

本文关键词： Crohn病体层摄影术螺旋计算机小肠活动度　出处：《中华消化病与影像杂志(电子版)》2016年02期 　论文类型：期刊论文

【摘要】：目的探讨多层螺旋CT小肠造影(MSCTE)评估克罗恩病活动度的临床价值。方法回顾性分析2014年1月至2015年6月在上海市第十人民医院经临床、内镜、病理学等方法证实并有完整MSCTE检查资料的克罗恩病患者68例,根据Harvey-Bradshaw指数(HBI)将患者分为活动期组41例与缓解组27例,比较两组间MSCTE表现差异;分析68例患者MSCTE表现与C反应蛋白(CRP)及红细胞沉降率(ESR)的相关性。结果活动期组肠壁厚度[(8.2±2.6)mm]及最大强化值[(112.8±16.4)HU]高于缓解期组的肠壁厚度[(5.4±1.6)mm]及最大强化值[(93.5±17.2)HU],差异均有统计学意义(P0.01)。活动期组肠壁分层样强化、"梳征"、系膜区淋巴结肿大、肠周蜂窝织炎、瘘管、肠管狭窄的发生率(88.5%、72.1%、77.0%、45.9%、26.2%、65.6%)高于缓解期组(29.6%、18.5%、25.9%、0、3.7%、37.0%),差异均有统计学意义(P0.05)。缓解期组肠壁均匀强化的发生率(70.4%)高于活动期组(11.5%),差异有统计学意义(P0.01)。活动期组肠周脓肿的发生率(14.8%)与缓解期组(3.7%)差异无统计学意义(P0.05)。CRP与肠壁厚度、肠壁强化值、肠系膜血管改变、淋巴结肿大、肠周蜂窝织炎、肠瘘有相关性(P均0.05);ESR与肠壁强化值、肠系膜血管改变、淋巴结肿大、肠周蜂窝织炎、肠瘘有相关性(P均0.05)。结论 MSCTE能充分显示肠壁表现及肠管外并发症,对评估克罗恩病的活动度有重要价值。CRP、ESR与MSCTE表现之间的相关性尚需进一步研究。
[Abstract]:Objective to investigate the MSCT of multislice spiral CT enterography (MSCT). To evaluate the clinical value of Crohn's disease activity. Methods Clinical data from January 2014 to June 2015 in 10th people's Hospital of Shanghai were retrospectively analyzed. There were 68 patients with Crohn's disease confirmed by endoscopy, pathology and complete MSCTE examination. According to Harvey-Bradshaw index, the patients were divided into active stage group (41 cases) and remission group (27 cases). The correlation between MSCTE and C-reactive protein (CRP) and erythrocyte sedimentation rate was analyzed in 68 patients. Results the intestinal wall thickness in active group was analyzed. [8.2 卤2.6 mm] and maximum enhancement value. [112.8 卤16.4 Hu] was higher than that in remission group. [5. 4 卤1. 6 mm] and maximum enhancement value. [The difference was statistically significant (P 0.01). In the active group, the intestinal wall was laminar enhancement, comb sign, mesenteric lymph node enlargement, periintestinal cellulitis, fistula. The incidence of intestinal stenosis was 88.5% and 77.1%, and 45.9% and 26.2k.65.6% higher than that in the remission group 29.618.5and 25.9%. The incidence of uniform enhancement of intestinal wall in remission group (70.4) was higher than that in active group (11.5m). The incidence of peri-intestinal abscess in active group (14.8%) was not significantly different from that in remission group (3.7%) (P 0.05). CRP and intestinal wall thickness. The enhancement value of intestinal wall, mesenteric vessel change, lymph node enlargement, periintestinal cellulitis and intestinal fistula were all 0. 05%. ESR was associated with intestinal wall enhancement, mesenteric vascular changes, lymphadenopathy, periintestinal cellulitis. Conclusion MSCTE can fully display the manifestation of intestinal wall and the complications of intestinal duct, and has important value in evaluating the activity of Crohn's disease. The correlation between ESR and MSCTE performance needs further study.
【作者单位】：云南省第三人民医院肝病中心;昆明医科大学第一附属医院肝病中心;上海市第十人民医院肝病中心;
【基金】：云南省自然科学基金资助项目(2012FD095) 云南省教育厅科研基金重点项目(2014Z125,2015Z146) 云南省临床重点专科建设项目(云卫医发〔2015〕18号)
【分类号】：R574.62;R816.5
【正文快照】： 克罗恩病(Crohn disease)是一种可累及消化道各部位,以末端回肠和邻近结肠多见的慢性肉芽肿性疾病[1]。正确评估克罗恩病的病情活动度对于选择治疗方案、检测疗效具有重要的指导意义[2]。目前,临床上评估克罗恩病活动度的方法有临床疾病活动度指数或哈维-布拉德肖指数(Harvey-

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