CAJ | 학술논문

目的：探讨MSCT对克罗恩病（Crohn’s disease ，CD）合并肛瘘以及CD活动期的诊断价值。方法：回顾性分析22例CD合并肛瘘患者的临床及影像资料，患者均行全腹部MSCT ，结合MSCT重建图像，分析病变肠壁的厚度、黏膜强化程度、肠系膜血管改变、肠系膜淋巴结、肠腔狭窄及肛瘘情况。结果：22例CD患者中15例经外科手术治疗肛瘘，其中复发7例，C T图像均表现为肠壁明显增厚、明显强化、肠系膜血管增多、肠系膜淋巴结增多、肠腔明显狭窄；未复发8例，CT 表现为肠壁增厚8例、肠壁明显强化1例、肠系膜血管增多3例、肠系膜淋巴结增多3例、肠腔狭窄4例。22例CD患者，C T表现为肠壁增厚21例（95.5％），肠壁强化22例（100％），肠系膜血管增多17例（77.3％），肠系膜淋巴结增多17例（77.3％），肠腔狭窄16例（72.7％）。结论：肛瘘是否术后复发与肠道病变的M SC T表现有关。
목적：탐토MSCT대극라은병（Crohn’s disease ，CD）합병항루이급CD활동기적진단개치。방법：회고성분석22례CD합병항루환자적림상급영상자료，환자균행전복부MSCT ，결합MSCT중건도상，분석병변장벽적후도、점막강화정도、장계막혈관개변、장계막림파결、장강협착급항루정황。결과：22례CD환자중15례경외과수술치료항루，기중복발7례，C T도상균표현위장벽명현증후、명현강화、장계막혈관증다、장계막림파결증다、장강명현협착；미복발8례，CT 표현위장벽증후8례、장벽명현강화1례、장계막혈관증다3례、장계막림파결증다3례、장강협착4례。22례CD환자，C T표현위장벽증후21례（95.5％），장벽강화22례（100％），장계막혈관증다17례（77.3％），장계막림파결증다17례（77.3％），장강협착16례（72.7％）。결론：항루시부술후복발여장도병변적M SC T표현유관。
Objective:To discuss the diagnostic value of Crohn's disease (CD) with anal fistula and the value of diagnosing the activity period of CD by multi-slice spiral computed tomography (MSCT ) .Methods :Retrospective analysis was made on the clinical and imaging data of 22 patients with CD complicated anal fistula ,all cases underwent total abdominal MSCT examina-tion ,combined with MSCT image reconstruction ,analysis of intestinal wall lesions ,enhancement of intestinal wall thickness , mesenteric vascular changes ,mesenteric lymph nodes ,lumen stenosis and fistula .Result:Among the 22 CD patients ,15 cases were by surgical operation treatment of anal fistula ,including 7 cases of recurrence ,CT images showed intestinal wall thicken-ing ,obvious enhancement ,mesenteric vessels increased ,mesenteric lymph nodes increased ,enteric stenosis .No recurrence in 8 cases ,CT images showed thickened bowel wall in 8 cases (100% ) ,bowel wall enhancement in 1 cases (12 .5% ) ,mesenteric vas-cular increased in 3 cases (37 .5% ) ,mesenteric lymph nodes increased in 3 cases (37 .5% ) ,lumen stenosis in 4 cases (50% ) .22 cases of CD patients ,CT showed the intestinal wall thickening in 21 cases (95 .5% ) ,bowel wall enhancement in 22 cases (100% ) ,mesenteric vascular increased in 17 cases (77 .3% ) ,mesenteric lymph nodes increased in 17 cases (77 .3% ) ,lumen stenosis in 16 cases (72 .7% ) .Conclusion:Recurrence of anal fistula of CD is relative with the intestinal performances of CD on MSCT .