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目的:探讨64层螺旋CT动态增强及三维重建技术在小肠克隆氏病中的价值。材料与方法:28例已知或怀疑小肠克隆氏病患者行常规CT平扫加动态增强检查,原始图像传送至工作站行三维重建后处理。仔细观察肠壁异常、黏膜及黏膜下溃疡、肠周围血管、瘘道、脓肿等。结果:28例病人诊断为小肠克隆氏病,共发现54段小肠病变。在活动性病变中,22例34段病变小肠肠壁增厚和强化,3例病变小肠明显强化而没有肠壁增厚,16例小肠与肠系膜边界模糊不清,肠系膜脂肪密度增厚,8例瘘管或瘘道形成,3例腹盆腔脓肿。在3例慢性感染性病变中,3例肠腔变形/狭窄,2例肠梗阻,1例穿孔,2例瘘管形成,1例合并硬化性胆管炎,1例合并肠淋巴瘤。结论:64层螺旋CT动态增强及三维重建技术在诊断小肠克隆氏病方面具有重要意义。
Objective: To investigate the value of 64-slice spiral CT dynamic enhancement and three-dimensional reconstruction in small bowel Crohn’s disease. MATERIALS AND METHODS: Twenty-eight patients with known or suspected small bowel Crohn’s disease underwent conventional CT scan and dynamic contrast enhancement. The original images were sent to the workstation for 3D reconstruction. Carefully observe the abnormal wall, mucosal and submucosal ulcers, perivascular blood vessels, fistula, abscess and so on. Results: 28 cases of patients diagnosed as Crohn’s disease, a total of 54 small intestinal lesions were found. In the active lesions, intestinal wall thickening and strengthening of small intestinal lesions in 22 cases of 34 lesions, 3 cases of lesion was significantly enhanced without wall thickening, 16 cases of small intestine and mesentery border ambiguous mesenteric fat density, 8 cases Fistula or fistula formation, 3 cases of pelvic abscess. Among 3 chronic infectious diseases, 3 had intestinal cavity deformation / stenosis, 2 had intestinal obstruction, 1 had perforation, 2 had fistula formation, 1 had sclerosing cholangitis and 1 had intestinal lymphoma. Conclusion: 64-slice spiral CT dynamic enhancement and three-dimensional reconstruction in the diagnosis of small bowel disease is of great significance.