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目的探讨回盲部Crohn病与结核的CT与MRI鉴别诊断征象。方法对35例经临床确诊的回盲部Crohn病(19例)与回盲部结核(16例)患者的影像资料进行回顾性分析,研究其肠壁厚度、肠周渗出、肠周淋巴结情况,将肠周渗出程度分为三级(无渗出、轻度渗出、重度渗出);对二者的肠周渗出程度、肠周淋巴结分别采用Pearson卡方检验,对二者病变肠壁的平均厚度行Wilcoxon秩和检验。结果 35例经临床证实的患者中,回盲部Crohn病肠周渗出程度无、轻、重分别为7例、11例、1例;回盲部结核肠周渗出程度无、轻、重分别为2例、4例、10例,二者差异有统计学意义(χ~2=13.248,P=0.001,P<0.05)。周围肠系膜淋巴结肿大分别为18例(18/19)及15例(15/16),差异无统计学意义(χ~2=0.874,P=0.646,P>0.05)。二者病变肠壁的平均厚度分别为10.0 mm及10.5 mm,差异无统计学意义(Z=-0.599,P=0.549,P>0.05)。CT与MRI对回盲部Crohn病与结核的诊断准确性分别为84.2%(16/19)和50.0%(8/16)。结论 CT与MRI能够显示回盲部病变的影像特征与病变范围,对诊断回盲部病变具有较高的准确性,是诊断与鉴别回盲部病变的有效手段。
Objective To investigate the differential diagnosis of CT and MRI between Crohn’s disease and tuberculosis in ileocecal region. Methods The clinical data of 35 cases of Crohn’s disease (19 cases) and ileocecal tuberculosis (16 cases) were retrospectively analyzed in the study. The changes of intestinal wall thickness, peri-intestinal exudation and intestinal lymph nodes , The peri-oointestinal exudation was divided into three levels (no exudation, mild exudation, severe exudation); Peri-intestinal exudation of both the intestinal lymph nodes were used Pearson Chi-square test, the two lesions The average thickness of the intestinal wall line Wilcoxon rank sum test. Results Among the 35 clinically confirmed patients, there was no intestinal exudation of Crohn’s disease in the ileocecal region. The severity of exudation was 7 cases, 11 cases and 1 case, respectively. There were 2 cases, 4 cases and 10 cases respectively. The difference was statistically significant (χ ~ 2 = 13.248, P = 0.001, P <0.05). There were 18 cases (18/19) and 15 cases (15/16) in the surrounding mesenteric lymph nodes, respectively. The difference was not statistically significant (χ ~ 2 = 0.874, P = 0.646, P> 0.05). The mean lesion wall thickness was 10.0 mm and 10.5 mm respectively, with no significant difference (Z = -0.599, P = 0.549, P> 0.05). The diagnostic accuracy of CT and MRI for Crohn’s disease and tuberculosis in the ileocecal region were 84.2% (16/19) and 50.0% (8/16), respectively. Conclusion CT and MRI can show the features of the ileocecal lesions and the extent of the lesions. It has high accuracy in diagnosing the ileocecal lesions and is an effective method to diagnose and identify the ileocecal lesions.