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目的探讨螺旋CT对小肠Crohn病的诊断价值。方法回顾性分析郸城县第二人民医院2009年1月至2013年6月收治的32例小肠Crohn病患者的临床资料,记录其螺旋CT的检查结果,如小肠受累的数目、肠壁厚度、黏膜改变、肠腔扩张或狭窄、肠道病理改变和并发症情况等。结果 32例患者均进行了螺旋CT检查,过程顺利,均未出现不良反应及意外情况。病变部位分布为单纯累及空肠6例,单纯累及回肠21例,同时累及空肠和回肠5例。CT显示患者肠壁有不同程度的增厚(≥3 mm),肠壁黏膜水肿,黏膜密度增大,急性期可见肠壁水肿呈现“分层状”或者“靶征”。6例患者可见肠腔狭窄或扩张。肠系膜血管增多、纠集,伴有邻近肠管受压变形等,8例患者肠系膜淋巴结肿大,伴有腹腔积液。有3例患者小肠外发现脓肿,周围出现蜂窝织炎、液体聚集,甚至有窦道形成。结论螺旋CT对小肠Crohn病具有较高的诊断价值,值得推广应用。
Objective To investigate the diagnostic value of spiral CT in the diagnosis of small intestine Crohn’s disease. Methods The clinical data of 32 patients with enteric Crohn’s disease from January 2009 to June 2013 in Second People’s Hospital of Dancheng County were retrospectively analyzed. The results of spiral CT examination, such as the number of intestinal involvement, the thickness of intestinal wall, Mucosal changes, expansion or narrow intestine, intestinal pathology and complications and so on. Results All the 32 patients underwent spiral CT examination, and the procedure was successful. No adverse reactions and unexpected events occurred. Sixty cases of jejunum were involved in the distribution of the lesion, 21 cases were involved in the ileum and 5 cases were involved in the jejunum and ileum. CT showed that patients with varying degrees of thickening of the intestinal wall (≥ 3 mm), intestinal mucosal edema, mucosal density increased, acute phase of intestinal wall edema showed “stratified ” or “target sign ”. Six patients showed intestinal stenosis or dilatation. Mesenteric blood vessels increased, gathered, accompanied by deformation of the adjacent bowel compression, mesenteric lymph nodes in 8 patients, accompanied by ascites. Three patients developed abscesses outside the small bowel, surrounded by cellulitis, fluid accumulation, and even sinusoids. Conclusion Spiral CT has a high diagnostic value for Crohn’s disease of small intestine and is worth popularizing.