Soyer Philippe, Boudiaf Mourad, Dray Xavier, Fargeaudou Yann, Vahedi Kouroche, Aout Mounir, Vicaut Eric, Hamzi Lounis, Rymer Roland
Department of Abdominal Imaging, and Clinical Research Unit, Hôpital Lariboisière-AP-HP-GHU Nord and Diderot-Paris 7 University, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France.
Radiology. 2009 Nov;253(2):416-24. doi: 10.1148/radiol.2532090533.
To describe the computed tomographic (CT) enteroclysis features of uncomplicated celiac disease (CD) and to determine the most indicative appearance of this condition by using a retrospective case-control study.
This study had institutional review board approval. The CT enteroclysis examinations of 44 consecutive patients with proved uncomplicated CD (21 men, 23 women; mean age, 44.45 years) were reviewed by two blinded readers and compared with those obtained in 44 control subjects (21 men, 23 women; mean age, 44.48 years), who were matched for sex and age. Comparisons were calculated by using univariate analysis.
Reversed jejunoileal fold pattern had the highest specificity (100%; 44 of 44; 95% confidence interval [CI]: 91.96%, 100%) and was the most discriminating independent variable for the diagnosis of uncomplicated CD (odds ratio, 39.9; P < .0001) but had a sensitivity of 63.64% (28 of 44; 95% CI: 47.77%, 77.59%). Ileal fold thickening, vascular engorgement, and splenic atrophy were other variables that strongly correlated with the presence of uncomplicated CD.
CT enteroclysis may help establish a diagnosis of uncomplicated CD and may clarify the cause of nonspecific gastrointestinal symptoms in patients with unknown CD. However, future prospective trials are needed to determine the actual value of CT enteroclysis in patients with CD and validate the clinical usefulness of CT enteroclysis in the detection of unknown uncomplicated CD.
描述单纯性乳糜泻（CD）的计算机断层扫描（CT）小肠造影特征，并通过回顾性病例对照研究确定该疾病最具指示性的表现。
本研究获得机构审查委员会批准。两名盲法阅片者对44例经证实为单纯性CD的连续患者（21例男性，23例女性；平均年龄44.45岁）的CT小肠造影检查进行回顾，并与44例对照者（21例男性，23例女性；平均年龄44.48岁）的检查结果进行比较，对照者在性别和年龄上进行了匹配。采用单因素分析进行比较。
空回肠襞模式反转具有最高的特异性（100%；44例中的44例；95%置信区间[CI]：91.96%，100%），是诊断单纯性CD最具鉴别力的独立变量（优势比，39.9；P <.0001），但敏感性为63.64%（44例中的28例；95%CI：47.77%，77.59%）。回肠襞增厚、血管充血和脾萎缩是与单纯性CD存在密切相关的其他变量。
CT小肠造影可能有助于确立单纯性CD的诊断，并可阐明CD患者非特异性胃肠道症状的原因。然而，需要未来的前瞻性试验来确定CT小肠造影在CD患者中的实际价值，并验证CT小肠造影在检测未知单纯性CD方面的临床实用性。
