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小肠克罗恩病(Crohn's Disease)CT病例图片影像诊断分析

时间:2011-02-12  来源:uhrad.com  作者:本站整理复制分享】【讨论-纠错】【举报

【临床病史】:为明确梗阻情况进行CT检查。Examination was performed to assess for obstruction.CId影像园XCTMR.com
影像图片】CT图像CId影像园XCTMR.com

小肠克罗恩病(Crohn\'s Disease)1.jpgCId影像园XCTMR.com

小肠克罗恩病(Crohn\'s Disease)2.jpgCId影像园XCTMR.com

小肠克罗恩病(Crohn\'s Disease)3.jpgCId影像园XCTMR.com

影像表现】:中腹区可见多个积液小肠环,但无明显扩张。回肠末端小肠壁轻度增厚,盲肠壁似乎亦增厚。另外整个小肠壁非连续性增厚。直肠壁增厚也显示增厚。未见明显肠腔外积液或炎症改变,未见明显肿大淋巴结。Examination of the patient's bowel reveals multiple fluid-filled loops of small bowel which are nondilated in the patient's mid abdomen. In the region of the terminal ileum, mild thickening of the small bowel wall is noted. Additionally, the cecum appears to be thick-walled in appearance. Additional regions of small bowel wall thickening are identified scattered throughout the patient's small bowel which are noncontinuous in nature. Thickening of the rectal wall is also appreciated. No evidence of extraluminal fluid collection or adjacent inflammatory change is identified. Additionally, there is no presence of associated adenopathy.CId影像园XCTMR.com
影像诊断】:克罗恩病(Crohn's Disease)CId影像园XCTMR.com

【诊断要点】:根据临床表现确定作钡剂小肠造影或钡剂灌肠,必要时可结合进行。可见多发性、节段性炎症伴僵硬、狭窄、裂隙状溃疡、瘘管、假息肉形成及鹅卵石样改变等。B超、CT、MRI检查可显示肠壁增厚、腹腔或盆腔脓肿等。CId影像园XCTMR.com
 【讨论】CId影像园XCTMR.com

详见:克罗恩病(Crohn病)CId影像园XCTMR.com

Crohn's disease also known as regional enteritis is a disease of unknown etiology. This lesion is characterized by segmental, noncontinuous lesions of full thickness, granulomatous involvement, with associated inflammation of the bowel wall. Hallmarks of this disease include skip lesions, regions of irregular stenoses, and fistula formation. This disease is found most commonly in the small bowel especially in the region of terminal ileum (80%). The colon is involved in 70% of patients. Duodenal involvement is seen in only 20% of patients.CId影像园XCTMR.com

Pathologically, this disease entity arises because of hyperplasia of the lymphoid tissue in the submucosa, which eventually leads to the presence of aphthoid ulcers with subsequent fistula formation, abscess formation, and potentially stricture formation.CId影像园XCTMR.com

Radiographically, on barium study, thickening of the folds may be seen. Additionally, a nodular pattern secondary to submucosal edema and/or inflammation may be seen. Classically a string sign, which is caused by tubular narrowing of the intestinal lumen due to the adjacent edema, may be identified. Ulcerations produce a nodular pattern, which has been typified as a (cobblestone) appearance. Sinus tracts and/or fistulas, adjacent inflammatory change of the mesentery, and/or fibrosis and scarring may also result.CId影像园XCTMR.com

Typically patients present with non-bloody diarrhea, abdominal pain, fever and malnutrition.CId影像园XCTMR.com

Associated findings may also include a sacroiliitis or arthritis of large joints in 10% of patients. Skin lesions of erythema nodosum may also be found.CId影像园XCTMR.com

References(参考文献):CId影像园XCTMR.com

  1. Gore R, Levine MS. Textbook of Gastrointesinal Radiology, CId影像园XCTMR.com
    1994. W. B. Saunders.
  2. Kirks DR. Practical Pediatric Imaging, 1992, Little Brown & Co.
  3. Weisslader R. Primer of Diagnostic Imaging, 1997, Mosby.

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