Pompili G G, Damiani G, Mariani P, Matacena G, Ardizzone S, Bianchi Porro G, Cornalba G
Reparto di Radiologia, Ospedale Luigi Sacco, Milano.
Radiol Med. 1994 Jul-Aug;88(1-2):44-8.
Fifty patients affected with Crohn's disease were examined with CT in a 12-month period; 39 of them underwent an intestinal enema and 24 a colon enema. Our goal was to assess the comparative contribution of CT and conventional radiology to the diagnosis of this disease. CT proved to be the method of choice to diagnose wall diseases with colon or small bowel wall thickening, which is usually homogeneous as demonstrated in 94% of the patients, intraabdominal abscesses in 3 patients (6%), perianal (4%), enterocutaneous (2%) and enteromuscle (2%) fistulas. CT was comparable to barium studies for rectovaginal (2%) and enterocolic (4%) fistulas. Conventional radiology was better than CT to assess mucosal diseases and ileum-ileal fistulas which were demonstrated with small bowel enema in 4 patients and in one patient only with CT. Therefore, we believe CT to be a complementary method to barium studies and a necessary tool for the correct staging of this disease, especially relative to the diagnosis of extramural lesions.
在12个月的时间里，对50例克罗恩病患者进行了CT检查；其中39例接受了肠道灌肠，24例接受了结肠灌肠。我们的目的是评估CT和传统放射学对该病诊断的相对贡献。CT被证明是诊断结肠或小肠壁增厚的壁疾病的首选方法，这种增厚通常是均匀的，94%的患者如此，3例患者（6%）有腹腔内脓肿，4%有肛周瘘，2%有肠皮肤瘘，2%有肠肌瘘。对于直肠阴道瘘（2%）和肠结肠瘘（4%），CT与钡剂造影相当。在评估黏膜疾病和回肠-回肠瘘方面，传统放射学比CT更好，4例患者通过小肠灌肠显示有回肠-回肠瘘，仅1例患者通过CT显示。因此，我们认为CT是钡剂造影的补充方法，也是该病正确分期的必要工具，特别是对于壁外病变的诊断。
