【摘要】 目的探讨小肠Crohn病的多层螺旋CT(MSCT)诊断价值。资料与方法回顾性分析经病理证实的35例小肠Crohn病的MSCT表现,分析病变肠管的数量、部位、肠壁厚度、增强后的强化特点及并发症。结果 MSCT均能显示小肠Crohn病的病变肠段,敏感性为100%。35例中共显示112段炎症肠壁,病变累及第6组小肠(回肠远段)35例,累及第5组、第4组、第3组、第2组分别为29例、16例、7例、4例,累及回盲部25例,广泛累及结肠4例。所有病例均表现为肠壁增厚,增强扫描显示病变肠壁有较明显强化,呈分层状或均一强化。肠系膜血管增生及"梳样征"21例,肠管周围蜂窝织炎13例,炎性肿块1例,瘘管2例,不全梗阻4例。结论 MSCT检查是小肠Crohn病的一种敏感的检查方法,小肠Crohn病的CT表现有一定特征性,可判断病变的活动性及疾病的发展阶段,对指导临床治疗具有重要意义。更多还原

【Abstract】 Objective To investigate the value of CT in the diagnosis of small intestinal Crohn’s disease.Materials and Methods The MSCT findings of 35 cases with pathology proved small intestinal Crohn’s disease were analyzed retrospectively,including the number,location of the involved bowel segment,thickness of the bowel wall and degree of contrast enhancement of the bowel wall as well as the existence of complications.Results The diseased bowel segment of every case was demonstrated in MSCT.The sensitivity was 100%.Totally 112 inflammatory segments were revealed.The sixth group of small bowel(distal ileum) was involved in 35 cases.The fifth,fourth,third and second group of small bowel were involved in 29,16,7 and 4 cases,respectively.The ileocecal area was involved in 25 cases,and extensive colon was involved in 4 cases.All patients suffered from bowel wall thickening,and various thickening and contrast enhancement multimode hybrid existed in the each case;mesangial proliferative blood vessels and the "comb-like" chang were seen in 21 cases,13 cases with phlegmon,one case with inflammatory mass,2 cases with fistula,and 4 cases with incomplete obstruction.Conclusion MSCT is a sensitive examination to diagnose small intestinal Crohn’s disease.Crohn’s disease represent typical features of Crohn’s disease in MSCT findings,which is helpful in judging the activity and staging of the disease and guiding the clinical treatment.更多还原