Tanabe Hiroki, Ito Takahiro, Inaba Yuhei, Ando Katsuyoshi, Nomura Yoshiki, Ueno Nobuhiro, Kashima Shin, Moriichi Kentaro, Fujiya Mikihiro, Okumura Toshikatsu
Department of Gastroenterology, Asahikawa Kousei Hospital, 111-3 1-Jodori 24-Chome, Asahikawa, Hokkaido 078-8211, Japan.
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa, Hokkaido 078-8510, Japan.
Eur J Radiol Open. 2017 May 5;4:58-62. doi: 10.1016/j.ejro.2017.04.003. eCollection 2017.
Endoscopic retrograde ileography (ERIG) is developed in our institute and applied clinically for the diagnosis and assessment of the Crohn's disease activity. We have further improved the technique using 3-dimensional - computed tomography enteroclysis (3D-CTE) and conducted a retrospective study to determine the feasibility and the diagnostic value of endoscopic retrograde 3D-CTE (ER 3D-CTE) in Crohn's disease patients in a state of remission.
Thirteen Crohn's patients were included in this pilot study. CTE was performed after the infusion of air or CO through the balloon tube following conventional colonoscopy. The primary endpoint of this study was to assess the safety of this method. Secondarily, the specific findings of Crohn's disease and length of the visualized small intestine were assessed.
The procedures were completed without any adverse events. Gas passed through the small intestine and enterographic images were obtained in 10 out of 13 cases, but, in the remaining patients, insertion of the balloon tubes into the terminal ileum failed. Various features specific to Crohn's disease were visualized using ER 3D-CTE. A cobble stone appearance or hammock-like malformation was specific and effective for diagnosing Crohn's disease and the features of anastomosis after the surgical operations were also well described. Therefore, this technique may be useful after surgery.
In this study, ER 3D-CTE was performed safely in Crohn's disease patients and may be used for the diagnosis and follow-up of this disease.
我院开展了内镜逆行回肠造影（ERIG）并将其应用于临床，用于诊断和评估克罗恩病的活动情况。我们采用三维计算机断层扫描小肠造影（3D-CTE）进一步改进了该技术，并进行了一项回顾性研究，以确定内镜逆行三维CT小肠造影（ER 3D-CTE）在缓解期克罗恩病患者中的可行性和诊断价值。
本初步研究纳入了13例克罗恩病患者。在常规结肠镜检查后，通过气囊导管注入空气或二氧化碳后进行CT小肠造影。本研究的主要终点是评估该方法的安全性。其次，评估克罗恩病的具体表现以及可视化小肠的长度。
操作过程未出现任何不良事件。13例患者中有10例气体通过小肠并获得了小肠造影图像，但其余患者将气囊导管插入回肠末端失败。使用ER 3D-CTE可观察到克罗恩病的各种特征。鹅卵石样外观或吊床样畸形具有特异性，对诊断克罗恩病有效，手术吻合口的特征也能很好地显示。因此，该技术在手术后可能有用。
在本研究中，ER 3D-CTE在克罗恩病患者中安全实施，可用于该疾病的诊断和随访。
