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目的探讨Crohn病的CT表现特点。方法回顾性分析经病理证实的18例Crohn病的CT征象,大多数病例采用螺旋CT或多层螺旋CT扫描。结果所有病例均有节段性肠壁增厚,CT增强有7例表现为肠壁均匀增厚,缺乏层次,同时肠壁强化不明显;有11例表现为黏膜增厚和分层形成“靶征”和“双环征”,肠壁厚度多在5～10mm;有9例表现为病变段肠管周围纤维脂肪成分增多,蜂窝织炎及肠周或肠系膜血管增多增粗。有5例CT首先考虑为其他疾病,1例考虑为闭攀性肠梗阻,1例首先考虑为肠结核,2例回盲部病变怀疑为癌,1例肠穿孔形成脓肿仅诊为化脓性感染。结论CT不但能准确显示Crohn病肠壁、肠系膜及周围结构的异常,增强CT还能区分活动性与非活动性病变,有助于临床采取合理而积极的治疗方案。
Objective To investigate the CT features of Crohn’s disease. Methods Retrospective analysis of pathologically confirmed CT signs of Crohn’s disease in 18 cases, most cases using spiral CT or multi-slice spiral CT scan. Results In all cases, segmental wall thickening was observed. In 7 cases of CT enhancement, the wall of the intestine was uniformly thickened and lacked, while the intestinal wall enhancement was insignificant. Eleven cases showed mucosal thickening and delamination formation Levy “and” double ring sign ", the thickness of intestinal wall is more than 5 ~ 10mm; there are 9 cases showed lesions of fibrous fat around the intestine increased, cellulitis and peritoneal or mesenteric blood vessels increased thickening. 5 cases of CT considered the first of other diseases, 1 case considered closed climbing intestinal obstruction, 1 case was first considered as intestinal tuberculosis, 2 cases of ileocecal lesions suspected of cancer, 1 case of intestinal perforation to form abscesses were diagnosed as purulent infection . Conclusion CT not only can accurately display the abnormalities of the intestinal wall, mesentery and surrounding structures of Crohn’s disease, but also enhance the CT to distinguish between active and inactive lesions, which is helpful for the rational and active clinical treatment.