回盲部Crohn病与结核的CT与MRI鉴别诊断

发布时间：2018-05-17 01:31

本文选题：回盲部 + 肠道疾病　；参考：《临床放射学杂志》2015年12期

【摘要】：目的探讨回盲部Crohn病与结核的CT与MRI鉴别诊断征象。方法对35例经临床确诊的回盲部Crohn病(19例)与回盲部结核(16例)患者的影像资料进行回顾性分析,研究其肠壁厚度、肠周渗出、肠周淋巴结情况,将肠周渗出程度分为三级(无渗出、轻度渗出、重度渗出);对二者的肠周渗出程度、肠周淋巴结分别采用Pearson卡方检验,对二者病变肠壁的平均厚度行Wilcoxon秩和检验。结果 35例经临床证实的患者中,回盲部Crohn病肠周渗出程度无、轻、重分别为7例、11例、1例;回盲部结核肠周渗出程度无、轻、重分别为2例、4例、10例,二者差异有统计学意义(χ~2=13.248,P=0.001,P0.05)。周围肠系膜淋巴结肿大分别为18例(18/19)及15例(15/16),差异无统计学意义(χ~2=0.874,P=0.646,P0.05)。二者病变肠壁的平均厚度分别为10.0 mm及10.5 mm,差异无统计学意义(Z=-0.599,P=0.549,P0.05)。CT与MRI对回盲部Crohn病与结核的诊断准确性分别为84.2%(16/19)和50.0%(8/16)。结论 CT与MRI能够显示回盲部病变的影像特征与病变范围,对诊断回盲部病变具有较高的准确性,是诊断与鉴别回盲部病变的有效手段。
[Abstract]:Objective to study the differential diagnosis of Crohn's disease and tuberculosis in ileocecal region by CT and MRI. Methods the imaging data of 35 patients with ileocecal Crohn's disease (19 cases) and ileocecal tuberculosis (16 cases) were retrospectively analyzed. The pericardial exudation degree was divided into three levels (no exudation, mild exudation, severe exudation, Pearson chi-square test was used for the pericardial lymph nodes, and Wilcoxon rank sum test was performed for the mean thickness of the intestinal wall of the two lesions. Results in 35 patients with clinically confirmed ileocecal Crohn's disease, the degree of perienteric exudation was no, mild, and severe in 7 cases and 11 cases, respectively, while in ileocecal tuberculosis there was no degree of perienteric exudation, light in 4 cases and severe in 4 cases, respectively. There was significant difference between the two groups (蠂 ~ (2 +) ~ (13.248) P ~ (0.001) P _ (0.05). The number of peripheral mesenteric lymphadenopathy was 18 / 19 (n = 18) and 15 / 15 / 16 respectively (蠂 ~ (2 / 2) 0.874 ~ (0.64) P ~ (0.05). The mean thickness of intestinal wall was 10.0 mm and 10.5 mm, respectively. There was no significant difference between the two groups. The diagnostic accuracy of CT and MRI for ileocecal Crohn disease and tuberculosis were 84.2% and 50.0%, respectively. Conclusion CT and MRI can display the imaging features and the range of ileocecal lesions, and have a high accuracy in the diagnosis of ileocecal lesions, which is an effective means to diagnose and differentiate ileocecal lesions.
【作者单位】：福建医科大学附属第一医院影像科;
【分类号】：R574;R445.2;R816.5

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