Song Kyoung Doo
J Korean Soc Radiol. 2023 May;84(3):536-549. doi: 10.3348/jksr.2023.0014. Epub 2023 May 9.
The two main types of inflammatory bowel disease (IBD) are Crohn's disease and ulcerative colitis. Currently, when IBD is suspected, CT enterography is widely used as an initial imaging test because it can evaluate both the bowel wall and the outside of the bowel, helping to differentiate IBD from other diseases. When IBD is suspected, it is necessary to distinguish between Crohn's disease and ulcerative colitis. In most cases this is not difficult; however, in some cases, it is difficult and such cases are called IBD-unclassified. CT findings are often non-specific for ulcerative colitis, making it difficult to differentiate it from other diseases using imaging alone. In contrast, characteristic CT findings for Crohn's disease are often helpful in diagnosis, although diseases, such as tuberculous enteritis can mimic Crohn's disease. Recently, mutations in the gene encoding a prostaglandin transporter called have been discovered as the cause of the disease in some patients with multiple ulcers and strictures, similar to Crohn's disease. Therefore, genetic testing is being used to make a differential diagnosis.
炎症性肠病（IBD）的两种主要类型是克罗恩病和溃疡性结肠炎。目前，当怀疑患有IBD时，CT小肠造影被广泛用作初始影像学检查，因为它可以评估肠壁和肠外情况，有助于将IBD与其他疾病区分开来。当怀疑患有IBD时，有必要区分克罗恩病和溃疡性结肠炎。在大多数情况下，这并不困难；然而，在某些情况下则很困难，此类病例被称为未分类的IBD。CT表现对溃疡性结肠炎而言往往不具有特异性，这使得仅通过影像学检查将其与其他疾病区分开来很困难。相比之下，克罗恩病的特征性CT表现通常有助于诊断，尽管诸如结核性肠炎等疾病可能会类似克罗恩病。最近，在一些有多处溃疡和狭窄、类似于克罗恩病的患者中，已发现一种名为前列腺素转运体的基因编码突变是该病的病因。因此，基因检测正被用于进行鉴别诊断。
