Ochsenkühn T, Herrmann K, Schoenberg S O, Reiser M F, Göke B, Sackmann M
Department of Medicine II, Institute of Clinical Radiology, Klinikum Grosshadern, University of Munich, Germany.
Scand J Gastroenterol. 2004 Oct;39(10):953-60. doi: 10.1080/00365520410003218.
Although Crohn disease (CD) can affect the entire alimentary tract, the proportion of patients with small-bowel inflammation proximal to the terminal ileum is still unclear. Magnetic resonance imaging (MRI) combined with small-bowel enteroclysis can detect inflammatory lesions of the small bowel. Hence, we applied MR-enteroclysis to assess the percentage of patients with small-bowel inflammation proximal to the terminal ileum among patients with CD and abdominal pain.
Twenty-five consecutive patients with low, active CD of the colon and/or terminal ileum and episodes of abdominal pain were examined by both MR-enteroclysis and conventional enteroclysis. The findings of MR-enteroclysis were compared with endoscopic and histological results in the terminal ileum and conventional enteroclysis in the small bowel proximal to the terminal ileum.
In 13 of the 25 patients, inflammation of the small bowel proximal to the terminal ileum was shown by MR-enteroclysis, whereas in only 4 of the 25 patients, signs of inflammation of the small bowel proximal to the terminal ileum were shown by conventional enteroclysis, all of which were demonstrated by MR-enteroclysis. MR-enteroclysis confirmed the findings in 22 of 25 patients in whom endoscopy and histology had shown inflammation (16 of 18) or no inflammation (6 of 7) of the terminal ileum.
In symptomatic patients with CD even of low activity, inflammation of the small bowel proximal to the terminal ileum is frequent.
尽管克罗恩病（CD）可累及整个消化道，但回肠末端近端小肠炎症患者的比例仍不明确。磁共振成像（MRI）联合小肠灌肠可检测小肠的炎性病变。因此，我们应用磁共振小肠造影来评估CD伴腹痛患者中回肠末端近端小肠炎症患者的比例。
对25例连续性结肠和/或回肠末端低度活动性CD且有腹痛发作的患者进行了磁共振小肠造影和传统小肠灌肠检查。将磁共振小肠造影的结果与回肠末端的内镜及组织学结果以及回肠末端近端小肠的传统小肠灌肠结果进行比较。
25例患者中，13例经磁共振小肠造影显示回肠末端近端小肠有炎症，而25例患者中只有4例经传统小肠灌肠显示回肠末端近端小肠有炎症迹象，且所有这些病例磁共振小肠造影均有显示。25例患者中，22例患者的内镜及组织学检查显示回肠末端有炎症（18例中的16例）或无炎症（7例中的6例），磁共振小肠造影证实了这些结果。
即使是低度活动性的有症状CD患者，回肠末端近端小肠炎症也很常见。
