Kishi T, Shimizu K, Hashimoto S, Onoda H, Washida Y, Sakaida I, Matsunaga N
1 Department of Radiology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
Br J Radiol. 2014 Dec;87(1044):20140367. doi: 10.1259/bjr.20140367. Epub 2014 Oct 28.
To evaluate the CT enteroclysis (CTE)/enterography findings of patients with small-bowel mucosal damage induced by aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) and to compare these findings with the duration of drug use and endoscopic findings.
CTE findings of 11 patients (22 lesions) with drug-induced small-bowel damage were reviewed, including 8 NSAID users and 3 aspirin users. Three patients were short-term users (6 months or shorter) and eight were long-term users (3 years or longer). Nine patients also underwent videocapsule endoscopy (VCE) or double-balloon enteroscopy (DBE).
Small-bowel abnormalities were visible in 8 of 11 patients (73%) on CTE. Multiple lesions were seen in five patients, including all short-term users. Lesions were classified into three types. Type 1 (mucosal patchy enhancement) was found in four of eight patients (50%, 12 lesions) all were short-term users. Small erosions with mild oedema/redness were shown by DBE. Type 2 (homogeneous hyperenhancement) was found in two of eight patients (25%, four lesions) who were long-term users. Large ulcers with marked oedema/redness were shown by DBE. Type 3 (stratification enhancement) was found in four of eight patients (50%, six lesions), both short-term and long-term users. Annular or large ulcers with strictures were shown by VCE or DBE.
On CTE, Type 1 lesions in patients with mostly short-term aspirin or NSAID use, Type 2 lesions in patients with long-term use and Type 3 lesions in both types of patients were detected. CTE may have usefulness for the detection of mild damage.
Small-bowel abnormalities owing to aspirin or NSAID present with three different patterns on CTE.
评估阿司匹林或非甾体抗炎药（NSAIDs）所致小肠黏膜损伤患者的CT小肠造影（CTE）/小肠成像表现，并将这些表现与用药时长及内镜检查结果进行比较。
回顾了11例（22处病损）药物性小肠损伤患者的CTE表现，其中8例为NSAIDs使用者，3例为阿司匹林使用者。3例为短期使用者（6个月或更短时间），8例为长期使用者（3年或更长时间）。9例患者还接受了视频胶囊内镜检查（VCE）或双气囊小肠镜检查（DBE）。
11例患者中有8例（73%）在CTE上可见小肠异常。5例患者可见多发病损，包括所有短期使用者。病损分为三种类型。1型（黏膜斑片状强化）见于8例患者中的4例（50%，12处病损），均为短期使用者。DBE显示有轻度水肿/发红的小糜烂。2型（均匀性强化）见于8例患者中的2例（25%，4处病损），为长期使用者。DBE显示有明显水肿/发红的大溃疡。3型（分层强化）见于8例患者中的4例（50%，6处病损），包括短期和长期使用者。VCE或DBE显示有狭窄的环形或大溃疡。
在CTE上，检测到主要为短期使用阿司匹林或NSAIDs患者的1型病损、长期使用者的s2型病损以及两类患者中的3型病损。CTE对轻度损伤的检测可能有用。
阿司匹林或NSAIDs所致小肠异常在CTE上呈现三种不同模式。
