CT小肠造影对克罗恩病和溃疡性结肠炎的鉴别诊断价值-东南大学学报医学版

CT小肠造影对克罗恩病和溃疡性结肠炎的鉴别诊断价值

单位：南京医科大学附属南京医院(南京市第一医院)医学影像科, 江苏南京 210006

分类号：R574.62

出版年·卷·期（页码）：2019·38·第三期（511-514）

摘要：

目的：采用CT小肠造影（CTE）成像，探讨克罗恩病（CD）和溃疡性结肠炎（UC）的影像表现差异。方法：收集2012年3月至2016年12月在我院消化内科住院，经CTE、内镜、病理或药物治疗后随访证实为CD患者31例（设为CD组）、UC患者25例（设为UC组），比较两组患者发病年龄和CTE影像表现的差异。结果：CD组患者发病年龄较UC组患者年轻（P=0.003）；31例CD组患者共发现病灶48处（小肠30处，回盲部6处，结直肠12处），25例UC注患者发现病灶86处（小肠0处，回盲部8处，结直肠78处），两组病灶分布差异有统计学意义（P=0.000）；CD组患者在静脉期强化程度高于UC组患者（P=0.003）；CD组有8例出现肠管周围蜂窝织炎，较UC组的0例差异有统计学意义（P=0.018）；CTE上两组患者在病变肠壁厚度、强化方式、淋巴结增大、梳征方面的差异无统计学意义。结论：CD患者在发病年龄、病灶分布、强化程度上不同于UC患者，CTE对两种疾病的鉴别诊断有重要价值。

Objective:To investigate the different features between Crohn's disease(CD) and ulcerative colitis(UC) on CT enterography(CTE) imaging. Methods:Thirty-one patients with CD and 25 patients with UC treated in the Dpartment of Gastroenterology of our hospital were enrolled in this study.All the patients were confirmed by CTE, endoscopy, pathology or follow-up after medication. The age of onset of the diseases and the features of CTE imaging in the two groups were compared. Results:The age of onset of patients in CD group was younger than that of the UC group(P=0.003). There were 48 lesions in patients of the CD group, of which 30 lesions were located in small intestine, 6 lesions in ileocecal junction and 12 lesions in colorectum. Eight-six lesions were found in patients of the UC group, of which 0 lesion was located in small intestine, 8 lesions in ileocecal junction and 78 lesions in colorectum. There were statistical differences in the distribution of lesions between the two groups(P=0.000). Lesions presenting enhancement in venous phase was more obvious in CD group(P=0.003). There were 8 cases with cellulitis in CD group, but no cases were found in UC group, the difference between the two groups being statistically significant(P=0.018). Conclusion:The age of onset, distribution of lesions and enhancement are different between the patients with Crohn's disease and those with ulcerative colitis. CTE plays a key role in the differential diagnosis of CD and UC.

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