影像学检查在小肠克罗恩病活动期与慢性期的诊断价值
Diagnostic value of imaging examination for intestinal Crohn′s disease in active and chronic phase
-
摘要:
目的 探讨CT、X线小肠钡餐造影及消化内镜检查对小肠克罗恩病活动期与慢性期的诊断价值。
方法 回顾性分析2008年6月至2011年8月苏北人民医院收治的39例克罗恩病患者的临床资料，根据病变是否有活动性将患者分为活动期组(28例)与慢性期组(11例)，比较两组患者的CT、X线小肠钡餐造影及消化内镜检查等影像学征象的差异，并通过与术中探查结果比较，评价影像学检查对克罗恩病的诊断效能。计数资料采用χ2检验。
结果 活动期组患者肠壁病变中分层增厚、水肿带、重度强化、溃疡，肠腔狭窄，肠外并发症中的肠瘘、蜂窝组织炎、淋巴结肿大、木梳征的发生率高于慢性期组相应指标的发生率，两组比较，差异有统计学意义(χ2=10.700，3.954，22.025，7.661，10.700，7.661，6.810，7.661，4.592，P<0.05)；慢性期组患者肠壁单层增厚、脂肪、轻度强化、不强化、炎性息肉，肠外并发症中的腹腔脓肿、炎性包块的其发生率高于活动期组相应指标的发生率，两组比较，差异有统计学意义(χ2=17.475，11.345，18.050，5.366，22.856，12.662，5.846，P<0.05)。CT检查诊断克罗恩病肠壁增厚、肠腔病变及肠外并发症的效能均较高，但难以诊断肠壁溃疡及炎性息肉；X线小肠钡餐造影及消化内镜检查诊断肠壁溃疡及炎性息肉的效能较高，但难以诊断肠壁增厚及肠外并发症。
结论 以CT检查为首选，辅助以X线小肠钡餐造影及消化内镜检查，有利于揭示克罗恩病的活动期与慢性期表现。
Abstract:Objective To investigate the diagnostic value of computed tomography, X ray enterography and digestive endoscopy for intestinal Crohn′s disease in active and chronic phase.
Methods The clinical data of 39 patients with Crohn′s disease who were admitted to the Subei People′s Hospital from June 2008 to August 2011 were retrospectively analyzed. All patients were divided into the active phase group (28 patients) and the chronic phase group (11 patients). The results of computed tomography, X ray enterography and digestive endoscopy of the 2 groups were compared. The accuracy of the 3 diagnostic methods was assessed by consulting the operative findings. The enumeration data were analyzed using the chisquare test.
Results The incidences of intestinal wall stratification, intesitnal edema strap, severe enhancement, ulcers, intestinal stenosis, intestinal fistula, phlegmon, swollen lymph nodes and comb sign in patients with active phase of Crohn′s disease were significantly higher than those with chronic phase of Crohn′s disease ( χ2 = 10.700, 3.954, 22.025, 7.661, 10.700, 7.661, 6.810, 7.661, 4.592, P <0.05). The incidences of intestinal wall thickening, intramural fat, mild enhancement, unenhancement, inflammatory polyps, abscesses and inflammatory masses in patients with chronic phase of Crohn′s disease were significantly higher than those with active phase of Chrohn′s disease ( χ2 =17.475, 11.345, 18.050, 5.366, 22.856, 12.662, 5.846, P <0.05). Computed tomography was effective in detecting intestinal wall thickening and extraintestinal complications of Crohn′s disease, but it was difficult in demonstrating ulcers and inflammatory polyps. X ray enterography and digestive endoscopy were effective in detecting ulcers and inflammatory polyps, but they were difficult in detecting intestinal wall thickening and extraintestinal complications of Crohn′s disease.
Conclusion Computed tomography combined with X ray enterography and digestive endoscopy is helpful in demonstrating the presentations of Crohn′s disease in active and chronic phase.-
Keywords:
- Crohn′s disease /
- Imaging examination /
- Diagnosis
-
计量
- 文章访问数: 10668
- HTML全文浏览量: 0
- PDF下载量: 0
下载:
