Park Yoon Hea, Chung Woo-Suk, Lim Joon Seok, Park Soo Jung, Cheon Jae Hee, Kim Tae Il, Kim Won Ho, Hong Sung Pil
From the *Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul; †Department of Diagnostic Radiology, Konyang University Hospital, Konyang University College of Medicine, Daejon; and ‡Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea.
J Comput Assist Tomogr. 2013 Sep-Oct;37(5):834-9. doi: 10.1097/RCT.0b013e31829e0292.
The aim of the present study was to evaluate the diagnostic role of computed tomographic enterography (CTE) in distinguishing Crohn disease (CD) from intestinal tuberculosis (ITB).
From January 2006 to August 2011, a total of 81 consecutive patients (64 patients with CD and 17 patients with ITB) who received CTE on the initial workup were included. In CTE, degree of bowel involvement (number and length), mural change (mural hyperenhancement, stratification, wall thickening, and distribution), adjacent mesenteric change (comb sign, fibrofatty proliferation, fistula, abscess, and lymphadenopathy), and peritoneal change (peritoneal thickening and ascites) were assessed.
Segmental involvement, comb sign, fibrofatty changes, moderate wall thickening, and asymmetric distribution were significantly more common in the patients with CD than those with ITB. A positive comb sign was the most suggestive finding of CD (sensitivity, 74.1%; specificity, 90.9%).
A positive comb sign is the most suggestive finding that differentiates CD from ITB.
本研究旨在评估计算机断层扫描小肠造影（CTE）在区分克罗恩病（CD）和肠结核（ITB）方面的诊断作用。
纳入2006年1月至2011年8月期间，共有81例连续接受CTE初始检查的患者（64例CD患者和17例ITB患者）。在CTE中，评估肠受累程度（数量和长度）、肠壁改变（肠壁强化、分层、肠壁增厚及分布）、相邻肠系膜改变（梳征、纤维脂肪增生、瘘管、脓肿及淋巴结病）以及腹膜改变（腹膜增厚和腹水）。
节段性受累、梳征、纤维脂肪改变、中度肠壁增厚及不对称分布在CD患者中比ITB患者更常见。阳性梳征是CD最具提示性的表现（敏感性74.1%；特异性90.9%）。
阳性梳征是区分CD和ITB最具提示性的表现。
