微创医学

目的探讨多层螺旋CT（MSCT）增强造影与肠镜在炎性肠病诊断中的应用价值。方法回顾性分析96例炎性肠病（58例溃疡性结肠炎和38例克罗恩病）患者的影像学资料、肠镜检查结果、手术病理结果，以手术病理作为“金标准”，分析MSCT增强造影与肠镜在炎性肠病中的诊断价值。结果MSCT增强造影对溃疡性结肠炎的检出率明显高于肠镜（P＜0.05）。MSCT增强造影与肠镜对克罗恩病的检出率比较，差异无统计学意义（P＞0.05）。MSCT增强造影对肠周淋巴结、结肠带消失、肠系膜增生、腹腔脓肿或瘘管形成、肠壁增厚、肠壁强化、肠周脂肪间隙模糊的检出率均高于肠镜检查（均P＜0.05）。肠镜对多发性息肉、肠壁溃疡及卵石征的检出率均高于MSCT增强造影（均P＜0.05）。MSCT增强造影对溃疡性结肠炎患者的肠系膜增生、腹腔脓肿或瘘管形成、肠周脂肪间隙模糊、多发炎性息肉、肠腔狭窄的检出率均低于克罗恩病（均P＜0.05）。肠镜对溃疡性结肠炎患者的肠壁溃疡检出率高于克罗恩病，卵石征、肠腔狭窄检出率低于克罗恩病（均P＜0.05）。结论MSCT增强造影对溃疡性结肠炎的诊断效能总体优于肠镜，而对于两种疾病病理状态的诊断，两种方法各有优缺点，联合两种检查方法或可弥补单独检查的不足。

ObjectiveTo investigate the application value of multi-slice spiral CT (MSCT) enhanced contrast and enteroscopy in the diagnosis of inflammatory bowel disease. MethodsRetrospective analysis of imaging data, enteroscopy findings, and surgical pathology results of 96 patients with inflammatory bowel disease (58 patients with ulcerative colitis and 38 patients with Crohn′s disease). The diagnostic value of MSCT enhance contrast and enteroscopy in inflammatory bowel disease was analyzed by taking surgical pathology results as the “gold standard”. ResultsThe detection rate of ulcerative colitis by MSCT enhance contrast was significantly higher than that by enterscopy (P＜0.05). There was no significant difference between MSCT contrast enhancement and enterscopy in the detection rate of Crohn′s disease (P＞0.05). As compared with enteroscopy, MSCT enhanced contrast has higher detection rates of perienteric lymph nodes, disappearance of colonic band, mesenteric hyperplasia, peritoneal abscess or fistulization, intestinal wall thickening, intestinal wall strengthening and perienteric fat space blurring (all P＜0.05). The detection rates of polyposis, intestinal ulcer and cobblestones by enteroscopy were higher than those by MSCT enhanced contrast (all P＜0.05). MSCT enhanced contrast showed that the detection rates of mesenteric hyperplasia, peritoneal abscess or fistulization, perienteric fat space blurring, multiple inflammatory polyp and intestinal stenosis in patients with ulcerative colitis were lower than those of Crohn′s disease (all P＜0.05).The detection rate of intestinal ulcer in patients with ulcerative colitis by enteroscopy was higher than that of Crohn′s disease, while the detection rate of cobblestones and intestinal stenosis were lower than those of Crohn′s disease (all P＜0.05). ConclusionMSCT enhanced contrast is generally superior to enteroscopy in the diagnosis of ulcerative colitis. For the diagnosis of the pathological states of two diseases, each of the two methods has advantages and disadvantages, combining the two examination methods may compensate the deficiency of the separate examination.