CAJ | 학술논문

目的：探讨CT小肠成像(CTE)对Crohn病的诊断价值。方法回顾经CTE检查、病理证实的Crohn病患者25例，两位医生在不知道病理的情况下采用盲法分别对其CTE表现进行分析。结果两位医生通过CTE诊断Crohn病的准确度分别为90.60%和87.40%，CTE可清晰显示Crohn病的病变部位及肠管改变，25例患者中，仅累及小肠的12例(48%)，其中单纯回肠末端或回盲部受累5例，小肠及结肠同时受累的10例(40%)，仅累及结肠的3例(12%)。所有25例Crohn病CTE均表现为肠管增厚、肠腔狭窄，增强扫描肠壁呈明显层样或整体强化，肠管轴位像见“靶”征，系膜血管增多、粗大。18例(72％)见“梳样”征。15例(60%)见肠系膜淋巴结增大，边缘清楚。2例(8%)可见内瘘形成，1例(4%)不全小肠梗阻。结论CTE检查能多方位显示肠壁、肠腔、肠系膜、腹腔内淋巴结的异常情况及相应的并发症，可以作为诊断Crohn病的首要检查方法。
목적：탐토CT소장성상(CTE)대Crohn병적진단개치。방법회고경CTE검사、병리증실적Crohn병환자25례，량위의생재불지도병리적정황하채용맹법분별대기CTE표현진행분석。결과량위의생통과CTE진단Crohn병적준학도분별위90.60%화87.40%，CTE가청석현시Crohn병적병변부위급장관개변，25례환자중，부루급소장적12례(48%)，기중단순회장말단혹회맹부수루5례，소장급결장동시수루적10례(40%)，부루급결장적3례(12%)。소유25례Crohn병CTE균표현위장관증후、장강협착，증강소묘장벽정명현층양혹정체강화，장관축위상견“파”정，계막혈관증다、조대。18례(72％)견“소양”정。15례(60%)견장계막림파결증대，변연청초。2례(8%)가견내루형성，1례(4%)불전소장경조。결론CTE검사능다방위현시장벽、장강、장계막、복강내림파결적이상정황급상응적병발증，가이작위진단Crohn병적수요검사방법。
Objective To evaluate the diagnostic value of CT imaging of the small intestine (CTE) for Crohn's disease. Methods 25 patients with pathologically confirmed and CTE examination were analyzed retrospectively. Two doctors without knowing pathological situations were blinded to analyze the performance of its CTE. Results Of two doctors diagnose Crohn's disease by CTE accuracy were 90.60% and 87.40%, CTE can clearly show lesions and bowel changes, in 25 patients, 12 cases involving only the small intestine (48%), which simple terminal ileum or ileocecal involvement in 5 cases, small intestine and colon simultaneously involved in 10 cases (40%), only 3 cases involving the colon (12%). All 25 cases of Crohn's disease CTE showed thickening of the bowel, intestinal stenosis, intestinal enhanced scan showed a layer-like or overall enhancement, bowel axial like to see a "target" sign, increased mesenteric vessels. 18 cases (72%) see "comb-like"symptoms. 15 cases (60%) see the mesenteric lymph node enlargement, clear edge. 2 cases (8%) seen in the fistula formation, one case (4%) incomplete small bowel obstruction. Conclusion CTE examination can multi-faceted display the abnormalities of intestinal wall, intestine, mesenteric, intra-abdominal lymph node and corresponding complications as a primary screening method can diagnose Crohn's disease.