Antes G
Abteilung für Radiologie, Klinikum Kempten-Oberallgäu.
Radiologe. 1998 Jan;38(1):41-9. doi: 10.1007/s001170050322.
Among the many inflammatory diseases of the colon, Crohn's disease and ulcerative colitis occur most frequently. For primary evaluation, endoscopy has widely replaced the barium enema (BE) as diagnostic method. BE, however can provide important additional informations in the differential diagnosis of chronic inflammatory colonic diseases. Purpose of this article is the demonstration of typical, but also of atypical radiological changes in different stages of Crohn's disease and ulcerative colitis, as well as calling attention to the importance of CT. A BE demands a refined examination technique using double contrast. All CT-examinations have to be scrutinized for changes of the bowel and mesentery. A dedicated spiral-CT examination might be indicated in a known disease in order to obtain special informations. The advantage of a BE over endoscopy is a clear and reproducible demonstration of the patterns of distribution and character of the disease as well as the detection of fistulae. The classification into one or the other disease entity can be better accomplished. CT is superior in detecting bowel wall thickening, extraintestinal disease and complications. In diagnostic imaging of chronic inflammatory bowel diseases, endoscopy and radiologic techniques are used complementarily.
在众多结肠炎症性疾病中，克罗恩病和溃疡性结肠炎最为常见。对于初步评估，内镜检查已广泛取代钡剂灌肠（BE）成为诊断方法。然而，BE在慢性炎症性结肠疾病的鉴别诊断中可提供重要的额外信息。本文的目的是展示克罗恩病和溃疡性结肠炎不同阶段的典型以及非典型放射学改变，并提醒注意CT的重要性。BE需要采用双重对比的精细检查技术。所有CT检查都必须仔细检查肠道和肠系膜的变化。对于已知疾病，可能需要进行专门的螺旋CT检查以获取特殊信息。BE相对于内镜检查的优势在于能清晰且可重复地显示疾病的分布模式和特征以及检测到瘘管。对疾病进行分类能更好地完成。CT在检测肠壁增厚、肠外疾病及并发症方面更具优势。在慢性炎症性肠病的诊断成像中，内镜检查和放射学技术相互补充使用。
