摘要目的 探讨MSCT双期动态增强扫描在小肠Crohn病中的应用价值.方法 45例经综合方法 诊断,并通过临床治疗证实的小肠Crohn病患者均行MSCT双期动态增强扫描,并在ADW4.2工作站进行后处理.测量患病肠段在不同期相内的CT值,采用方差分析比较其CT值;并测量各期相内患病肠段与正常肠段的CT值筹值,以差别10 HU为界,划分病例数,将不同期相内的病例数采用卡方检验进行比较.结果病变肠段平扫平均CT值为(39.3±3.7)HU,动脉期为(74.8±13.8)HU,门静脉期为(90.2±12.3)HU,差异有统计学意义(F=258.87,P<0.01).病变肠段平扫与动脉期和门静脉期CT值两两比较,差异均有统计学意义(P<0.05).45例中,平扫CT值差值≤10 HU和>10 HU者分别为44和1例,动脉期分别为6和39例,门静脉期分别为2和43例,经X2检验,平扫与动脉期间差异有统计学意义(X2=32.49,P<0.01),平扫与门静脉期间差异有统计学意义(X2=39.22,P<0.01),动脉期与门静脉期间差异无统计学意义(X2=1.10,P>0.05).增强扫描使病灶显示更为清楚,大大提高了小肠Crohn病的检出率.结论 MSCT双期动态增强扫描可对小肠Crohn病作出初步诊断,并可对病变进行全面评价.
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abstractsObjective To assess the value of enhanced MSCT scan for the Crohn's disease of small bowel.Methods Fourty-five patients of small bowel Crohn's disease who were proved by multi-methed were examined by two-phase enhanced scan with MSCT.The images were reformed in ADW 4.2 by MPR mainly.The CT values of the lesion segments in different phases were tested, with one way ANOVA in statistical analysis; the density difference between the lesion segments and normal segments in different phases were tested,the cases were divided according to 10 HU,and compared them with each other by X2 test.Results The average CT value of lesion segments was (39.3±3.7) HU in plain scan, (74.8 ± 13.8) HU in artery phase, (90.2 ± 12.3) HU in portal vein phase, there were sinigicant difference in them(F =258.87,P < 0.01).There were sinigicant difference in CT value of lesion segments between any phase and other two phases (P < 0.05).In 45 cases, there were 44 cases and one case that the difference of CT value were ≤±10 HU and > 10 HU respectively in plain scan, 6 cases and 39 cases in artery phase, 2 cases and 43 cases in portal vein phase, by X2 test, there were sinigicant difference betwwen plain scan and artery phase(X2 =32.49,P <0.01), and significant difference between plain scan and portal vein phase(X2 = 39.22,P <0.01), there were no significant difference between artery phase and portal vein phase (X2 = 1.10,P>0.05).After enhancement, the lesions can display clearly than plain scan, and the detectable rate was raised highly.Conclusion Two-phase enhancement scan can diagnosis the Crohn's disease of small bowel and evaluate it overall.
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