【摘要】 目的探讨CT鉴别克罗恩病活动度的临床价值,为克罗恩病的相关治疗与临床评价提供参考。资料与方法回顾性分析经肠镜、病理或临床确诊为克罗恩病的35例患者的临床资料。依据克罗恩病活动指数(CDAI)评分结果将患者分为A组(CDAI≤220)和B组(CDAI>220)。比较两组患者急性C反应蛋白(CRP)和红细胞沉降率(ESR);并分析CDAI、CRP、ESR值与CT征象之间的相关性。结果 A组中,肠壁分层强化2例、肠系膜血管增生7例,平均病变肠壁厚度(7.0±1.7)mm,肠系膜淋巴结动脉、静脉期相对强化值分别为(38.7±20.3)Hu和(34.7±24.4)Hu,均显著低于B组,差异有统计学意义(P<0.05)。病变累及肠段数(ρ=0.69)、肠系膜血管增生(ρ=0.66)、肠壁周围炎(ρ=0.63)与CDAI值呈中度正相关(P<0.05)。结论CT可直观显示克罗恩病患者病变肠腔内外情况,其CT征象,尤其是肠系膜相关征象对于鉴别克罗恩病的临床活动度具有重要价值。更多还原

【Abstract】 Purpose To discuss the clinical value of CT in identifying the activity of Crohn’s disease, and to provide a method for the treatment and clinical evaluation of Crohn’s disease. Materials and Methods A retrospective analysis was performed on the clinical data of 35 patients diagnosed as Crohn’s disease by endoscopy, pathology or clinic. According to the Crohn’s disease activity index(CDAI) scores, all the patients included in the study were divided into group A(CDAI≤220) and group B(CDAI>220), and then the acute c-reactive protein(CRP) and erythrocyte sedimentation rate(ESR) were compared between the two groups, finally, the correlation between CDAI, CRP, ESR and CT signs was analyzed. Results In group A, there were two cases of intestinal wall stratification enhancement and seven cases of mesenteric angiogenesis, and the average lesion intestinal wall thickness was(7.0±1.7) mm, while the relative enhancement value of mesenteric lymph nodes in arterial and venous phase was(38.7±20.3) Hu and(34.7±24.4) Hu, respectively,which were both lower than that of group B. The difference was statistically significant(P<0.05). In addition, the number of intestinal segments involved in lesion(ρ=0.69), the mesenteric angiogenesis(ρ=0.66) and peri-intestinal inflammation(ρ=0.63) were positively correlated with CDAI value moderately(P<0.05). Conclusion The CT could visually show the intra-and extra-intestinal lesion in patients with Crohn’s disease, and the CT signs, especially the mesenteric signs, are of significant value in the identification of clinical activity of Crohn’s disease.更多还原