摘要
目的 探讨小肠CT造影(CTE)对儿童克罗恩病临床活动分期的应用。资料与方法 回顾性收集2019年1月—2022年10月首都儿科研究所附属儿童医院收治的83例临床确诊儿童克罗恩病的临床及CTE影像学资料,依据儿童克罗恩病活动指数分为4组(缓解期11例、轻度活动期47例、中度活动期14例、重度活动期11例),收集CTE的各项参数指标,并分析CTE评估与儿童克罗恩病活动度分期的相关性。结果 4组CTE影像表现中,病变肠管范围(χ^(2)=49.934)、肠壁强化方式(χ^(2)=56.561)、肠管狭窄程度(χ^(2)=31.932)、肠壁厚度(χ^(2)=46.535)、肠周淋巴结肿大(χ^(2)=17.330)差异有统计学意义(P<0.05)。儿童克罗恩病活动指数活动期病变(轻-重度活动期)CTE影像表现为受累肠管范围大(>50 mm)(31例,37.3%)、肠壁分层强化多见(27例,32.5%)、肠腔狭窄(<5 mm)(19例,22.9%)及肠壁明显增厚(>5.0 mm)(54例,65.1%)、肠周淋巴结肿大(>7 mm)(16例,19.3%)出现比例高。其中病变肠管范围(r=0.500)、病变肠壁强化方式(r=0.574)、肠腔狭窄(r=0.316)、肠壁增厚(r=0.533)与儿童克罗恩病临床活动分期呈正相关(P均<0.01)。结论 随着病变肠管范围增加、病变肠壁强化方式(均匀-分层)、肠腔狭窄及肠壁增厚程度加重,临床活动分期也逐渐加重,以上4项指标可作为反映儿童克罗恩病活动分期的特征性指标。
Purpose To explore the application value of computed tomography enterography(CTE)in differentiating active staging of pediatric Crohn disease.Materials and Methods The clinical data of 83 pediatric Crohn disease children performed by CTE examination and conducted with pediatric Crohn disease activity index(PCDAI)from January 2019 to October 2022 were selected.According to their different PCDAI scores,the patients were divided into four groups,which were remission stage(11 cases),mild activity period(47 cases),moderate activity period(14 cases)and severe activity period(11 cases),and the parameters of CTE were analyzed.Then the results associated with CTE and the stages of pediatric Crohn disease activity were analyzed.Results The CTE images of different clinical PCDAI activity stages were manifested in the scope of the diseased intestine(χ^(2)=49.934),the enhancement mode of diseased intestinal wall(χ^(2)=56.561),the degree of intestinal cavity stenosis(χ^(2)=31.932),the degree of intestinal wall thickened(χ^(2)=46.535),lymph node enlargement(χ^(2)=17.330);in which there was a significantly difference(P<0.05),respectively.With the aggravation of PCDAI activity stages,the extent of diseased intestinal canal(more than 50 mm,31 cases,37.3%),the layered reinforcement of diseased intestinal wall(27 cases,32.5%),the luminal stenosis(less than 5 mm,19 cases,22.9%),the thickening of intestinal wall(more than 5.0 mm,54 cases,65.1%)were more common.The proportion of occurrence in the enlargement of lymph nodes(more than 7 mm,16 cases,19.3%)was high,with significant statistical significance(P<0.05).Spearman correlation analysis showed that there was a significant positive correlation between pediatric Crohn disease clinical activity stage(all P<0.01)and the extent of the lesion intestinal canal(r=0.500),the enhancement mode of the lesion intestinal wall(r=0.574),the luminal stenosis(r=0.316),the thickening of intestinal wall(r=0.533).Conclusion With the extent of diseased intestinal canal,the degree of the luminal sten
作者
吴朔春
钟雪梅
仪晓立
陶然
杨梅
孙雪峰
WU Shuochun;ZHONG Xuemei;YI Xiaoli;TAO Ran;YANG Mei;SUN Xuefeng(Department of Radiology,Children’s Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2024年第6期591-596,共6页
Chinese Journal of Medical Imaging
关键词
克罗恩病
小肠CT造影
临床活动分期
儿童
Crohn disease
Computed tomography enterography
Active staging
Children
