van den Bosch H C, Tjon a Tham R T, Gooszen A W, Fauquenot-Nollen J M, Lamers C B
Department of Diagnostic Radiology, Catharina Ziekenhuis, Eindhoven, The Netherlands.
Radiology. 1996 Dec;201(3):803-8. doi: 10.1148/radiology.201.3.8939235.
To correlate the radiologic, histopathologic, and clinical findings in patients with celiac disease after treatment with a glutenfree diet.
Pretreatment and follow-up enteroclysis radiographs from 15 adult patients with known celiac disease were reviewed. Diagnosis of celiac disease was made at adult age. Changes in small-bowel morphology were determined by comparing enteroclysis findings before and after treatment with a gluten-free diet and were correlated with histopathologic and clinical findings.
Eight of 15 patients (group I) showed increased small-bowel abnormalities. All patients had increased symptoms, and all but one, whose condition had deteriorated, showed stable disease at biopsy. Group II patients (five of 15) showed improvement at follow-up enteroclysis. Biopsy findings showed improvement in small-bowel morphology in four patients and no change in one. Clinically, four patients showed improvement, and one had stable disease. Group III patients (two of 15) showed no change from initial to follow-up enteroclysis. Both showed partial atrophy, which was consistent with biopsy findings. In all patients, clinical symptoms correlated better with enteroclysis results (r = .48; P < .005) than they did with follow-up biopsy results (r = .18). True celiac disease-related malignancies and coexisting tumors occurred in 10 of 15 patients.
Enteroclysis appears to be more reliable than does biopsy in evaluation of response to a gluten-free diet in adults with celiac disease.
将乳糜泻患者接受无麸质饮食治疗后的放射学、组织病理学和临床结果进行关联。
回顾了15例已知患有乳糜泻的成年患者的治疗前和随访小肠灌肠造影X线片。乳糜泻诊断于成年期作出。通过比较无麸质饮食治疗前后的小肠灌肠造影结果来确定小肠形态的变化，并将其与组织病理学和临床结果相关联。
15例患者中有8例（第一组）小肠异常增多。所有患者症状均加重，除1例病情恶化外，其余患者活检时疾病均稳定。第二组患者（15例中的5例）随访小肠灌肠造影显示改善。活检结果显示4例患者小肠形态改善，1例无变化。临床上，4例患者症状改善，1例病情稳定。第三组患者（15例中的2例）从初始到随访小肠灌肠造影无变化。两者均显示部分萎缩，与活检结果一致。在所有患者中，临床症状与小肠灌肠造影结果的相关性（r = 0.48；P < 0.005）优于与随访活检结果的相关性（r = 0.18）。15例患者中有10例发生了真正的乳糜泻相关恶性肿瘤和并存肿瘤。
在评估成年乳糜泻患者对无麸质饮食的反应时，小肠灌肠造影似乎比活检更可靠。
