多层螺旋CT和三维重建技术在克罗恩病诊断中的应用价值

摘要

Objective To investigate the clinical value of multislice spiral CT combined with 3-dimensional re-construction in the diagnosis of Crohn's disease.Methods The features of multislice spiral CT combined with 3-dimen-sional reconstruction were analysed in 46 patients with(CD)confirmed by endoscope or pathology.Results In 46 pa-tients with CD,42 cases were in activation stage and 4 cases in remission stage.In 42 cases of patients with CD in acti-vation,6 cases were colonic,18 cases were back to the colon and 18 cases were small intestine.All CD patients in activa-tion had active bowel wall thickening and were significantly strengthened after enhancement.The main way to strengthen was hierarchical reinforcement ring,33 cases of segmental lesions,32 cases of increased density gap of mesenteric fat, fuzzy,28 cases of mesenteric vascular thickening,increased twisted,30 cases of mesenteric lymph nodes around,2 cases of abdominal abscess,1 case of psoas abscess,6 cases of incomplete intestinal obstruction and intestinal fistula was not found.In 4 cases of patients with CD in remission,only 1 patient was found to have incomplete intestinal obstruction and 4 cases had no other abnormalities.Conclusion Multislice spiral CT combined with 3-dimensional reconstruction has a significant value in the clinical diagnosis of the position,type,stage and the complications of CD.%目的探讨多层螺旋CT和三维重建技术在克罗恩病（CD）诊治中的临床应用价值。方法回顾性分析46例经内镜或病理证实的CD患者的多层螺旋CT和三维重建征象，评价多层螺旋CT和三维重建技术在CD患者临床诊治中的价值。结果46例CD患者中活动期42例，缓解期4例。在42例活动期患者中结肠型6例，回结肠型18例，小肠型18例。所有活动性患者中多层螺旋CT和三维重建显示均有肠壁增厚、增强后明显强化，强化方式主要为环形分层强化，病变呈节段性33例，肠系膜脂肪间隙密度增高、模糊32例，肠系膜血管增粗、增多、扭曲28例，肠系膜周围淋巴结肿大30例，腹腔脓肿2例，腰大肌脓肿1例，不全性肠梗阻6例，未发现肠瘘。4例临床缓解期患者的中仅1例发现有不全性肠梗阻，4例患者均无其他异常。结论多层螺旋CT和三维重建技术在CD的定位、分型、分期、并发症的临床诊断中具有重要意义。