The value of CT enteroclysis in the diagnosis of Crohn’ s disease

LIU Shaowei; ZHOU Zhongheng; LIU Yongkang; CHEN Xiao

Abstract：Objective The purpose of this study was to explore the value of CT enteroclysis(CTE) in the diagnosis and as-sessment of Crohn’ s disease ( CD) .Methods The clinical and imaging data of 24 CDs confirmed by enteroscope or surgery were analyzed retrospectively, including the gender, age, clinical symptoms, lesion location, intestinal wall thickening, enhancement mode, luminal stenosis, mesenteric vascular, peripheral lymph node and several complications such as incomplete ileus, anal fis-tula, et al.Results In 24 patients (7 women, 17 men;mean age, 35.5 years) with known CD, the clinical manifestations in-cluded stomachache (75%,18/24), diarrhea (70.8%, 17/24), bloody stools or bloody purulent stool (25%, 6/24) anal fistu-la (50%, 12/24).The CTE showed lesions involved in small intestine (16 cases), ileocecal junction or terminal ileum (20 ca-ses), and colon (12 cases).The intestinal wall presented multiple segmental thickening with cloddy transformation in two cases. All lesions were inordinately enhanced after the contrast agent injection, single stratification enhancement in 4 cases (16.7%), mural stratification enhancement in 20 cases (83.3%) , and one case showed enhanced mass.The mesenteric vascular increased and roughened, and typical “comb sign” was observed in 8 cases.Luminal stenosis, incomplete ileus, anal fistula was found in 16, 4 and 12 cases, respectively.There’ s no intraperitoneal abscess and enterobrosis in all cases.Conclusion CTE can clearly showed the intestinal wall and is extra-intestinal complication of CD, and proved to be valuable in diagnosis of CD.The typical imaging findings of CD in CT include multiple segmental intestinal wall thickening and enhanced, mesenteric vascular increased and roughened with typical“comb sign”, perienteric lymph node reactive proliferation.Some patients may have several complica-tions such as intestinal stenosis and secondary obstruction anal fistula.