【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,P<0.05)。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,P>0.05)。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,P>0.05)。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。更多还原

【Abstract】 Objective To evaluate the clinical value of CT and MRI in the diffetential diagnosis of ileocecal Crohn’s disease and tuberculosis. Methods Thirty-five patients,including ileocecal Crohn disease( n = 19) and ileocecal tuberculosis( n = 16),who were confirmed by clinical results,underwent CT or MRI examinations. The degree of peri-ileocecal fat strangding and the enlarged mesenteric lymph nodes were analyzed by using Pearson χ2test. The average bowel wall thickness between the two diseases was assessed by using Wilcoxon signed-rank test. The accuracy of diagnosis was calculated. Results The accuracy of imaging in identifying patients with Crohn’s disease and tuberculosis was 84. 2%( 16 /19) and 50. 0%( 8 /16),respectively. The average bowel wall thickness of the two groups was 10. 0 mm and 10. 5 mm,respectively,and showed no significant difference between them( Z =- 0. 599,P = 0. 549,P > 0. 05). The lymph nodes in mesentery were found in 18( 18 /19) cases in Crohn’s disease group and 15( 15 /16) cases in tuberculosis group,and showed no significant difference between them( χ~2= 0. 874,P = 0. 646,P > 0. 05). A mild degree of mesenteric fat stranding was seen in eleven patients with Crohn’s disease and four patients with tuberculosis. And the severe degree of mesenteric fat stranding was seen in one patients with Crohn’s disease and ten patients with tuberculosis and showed a significant difference between them( χ~2= 13. 248,P = 0. 001,P < 0. 05). Conclusion CT and MRI can depict the imaging characteristics and the extension of ileocecal Crohn’s disease and tuberculosis clearly. They can provide a fairly high accuracy in characteristic diagnosis and play an effective role in diagnosis of ileocecal diseases.更多还原