CT结肠成像对炎症性肠病的诊断价值

目的:探讨CT结肠成像(CTC)在炎症性肠病(IBD)诊断中的价值。方法:回顾性分析我院经结肠镜活检病理证实的7例IBD的CTC资料并文献复习。结果:7例IBD中克罗恩病(CD)4例、溃疡性结肠炎(UC)3例。4例CD的CTC主要表现为病变呈多节段性,病变段肠壁明显增厚、强化,病变段管腔狭窄,导航下病变段肠壁黏膜面凹凸不平呈鹅卵石状,肛周及回盲部周围脓肿并瘘道形成。3例UC的CTC导航下见整个直结肠黏膜面弥漫分布多个浅表溃疡灶,溃疡部位黏膜面毛糙、肠壁轻度不规则增厚、肠壁轻到中等度强化。结论:CTC可多方位、多角度观察肠壁、肠腔或肠外病变,形成整体的二维、三维结肠影像,为临床提供比结肠镜更丰富的信息,对IBD的诊断有其独特的优越性。

Diagnostic value of CT colonoscopy in inflammatory bowel disease:Report of 7 cases with literature review

Objective： To assess the value of computed tomographic colonoscopy（CTC） in diagnosis of inflammatory bowel diseases （IBD）. Methods：Retrospective study was conducted on the CTC findings, with literature review, in 7 IBD cases confirmed pathologically in our hospital. Results：Of the 7 cases, 4 were Crohn＇s disease（CD） and 3 were ulcerative colitis（UC）. CTC revealed skip lesions, significantly thickened bowel wall and enhancement of invaded bowel, constricted lumen of the diseased segment, unsmooth and cobblestone-appearance mucosa and peritoneal formation of abscess and fistula for the 4 cases of CD, and the 3 with UC were seen small superficial erosions and larger ulcerations of rectal and colon in an uninterrupted manner with rough mucosa, lightly and irregularly thickened bowel wall and slight enhancement of invaded mucosa. Conclusion：CTC can virtually identify the lesions of the intestinal wall, enteric cavity and extraintestinal in all dimensions, and is greatly valuable in diagnosis of IBD, for it may provide clinicians with more specific information than sole fiberoptic cotonoscopy does.