内脏脂肪作为克罗恩病和肠结核鉴别诊断中的一个有用参数。
Visceral fat as a useful parameter in the differential diagnosis of Crohn's disease and intestinal tuberculosis.
作者信息
Ko Jun Kwon, Lee Hang Lak, Kim Jin Ok, Song Soon Young, Lee Kang Nyeong, Jun Dae Won, Lee Oh Young, Han Dong Soo, Yoon Byung Chul, Choi Ho Soon, Hahm Joon Soo, Kim Sang-Yeon
机构信息
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Department of Radiology, Hanyang University College of Medicine, Seoul, Korea.
出版信息
Intest Res. 2014 Jan;12(1):42-7. doi: 10.5217/ir.2014.12.1.42. Epub 2014 Jan 28.
BACKGROUND/AIMS: Because of the similarities in the clinical presentations of Crohn's disease (CD) and intestinal tuberculosis (ITB), differential diagnosis is critical. Mesenteric adipose tissue hypertrophy and creeping fat are characteristic features of CD. The purpose of this study was to assess the usefulness of visceral fat for the differential diagnosis of CD and ITB.
METHODS
We conducted a retrospective review of 50 patients with findings of CD or ITB between January 2005 and July 2008. Abdominal computed tomography (CT) was performed on all subjects during their first evaluation. The abdominal fat area was assessed using quantitative abdominal CT.
RESULTS
The ratio of visceral fat to total fat (VF/TF) was significantly higher in male CD patients than in male ITB patients. The ratio of visceral fat to subcutaneous fat (VF/SF) was also higher in CD patients than in patients with ITB. For a VF/TF cut-off value of 0.46, the sensitivity and specificity for the diagnosis of CD were 42.1% and 93.3% respectively, with positive and negative predictive values of 88.9% and 56.0%, respectively.
CONCLUSION
Measurement of the abdominal fat area using CT can be clinically useful for the differential diagnosis of CD and ITB.
背景/目的：由于克罗恩病（CD）和肠结核（ITB）临床表现相似，鉴别诊断至关重要。肠系膜脂肪组织肥大和匐行脂肪是CD的特征性表现。本研究旨在评估内脏脂肪在CD和ITB鉴别诊断中的作用。
方法
我们对2005年1月至2008年7月间50例诊断为CD或ITB的患者进行了回顾性研究。所有受试者在首次评估时均进行了腹部计算机断层扫描（CT）。采用定量腹部CT评估腹部脂肪面积。
结果
男性CD患者内脏脂肪与总脂肪的比值（VF/TF）显著高于男性ITB患者。CD患者内脏脂肪与皮下脂肪的比值（VF/SF）也高于ITB患者。当VF/TF临界值为0.46时，诊断CD的敏感性和特异性分别为42.1%和93.3%，阳性预测值和阴性预测值分别为88.9%和56.0%。
结论
利用CT测量腹部脂肪面积对CD和ITB的鉴别诊断具有临床应用价值。
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