Assessment Of The Diagnostic Value Of Multi-slice CT Enterography In Patients With Crohn's Disease

Objective:To investigate the value of multi-slice CT enterography(CTE) in the diagnosis of Crohn's disease.Methods:60 patients with histologically proven Crohn's disease underwent CTE. Imaging findings were analyzed retrospectively. Imaging findings of 23 patients who underwent SBFT and CTE (interval range,l-30days; mean interval,8 days) were analyzed and compared retrospectively.Results:Among the 60 cases, there were 43 cases(72%) of skip lesions.21 cases(35%) had lesions limited to the small intestine, the small intestine and the colon were involved simultaneously in 35 cases(58%), only 4 cases (7%) had lesions limited to the colon. Among 56 cases(93%) which had small intestinal lesions, the terminal ileum was involved in 39 cases (70%). The findings of those patients on MSCTE were 60 cases(100%) of bowel wall thickening,58 cases(97%) of mural hyperenhancement,39 cases(65%) of mural stratification,32 cases(53%) of stenosis,5 cases(8%) of mural abscess,39 cases(65%) of increased mesenteric vascularity(comb sign),19 cases(32%) of fibrofatty proliferation,40 cases(67%) of phlegmon,13 cases(22%) of abscesses or inflammatory masses,15 cases(25%) of fistulas/sinus tracts,12 cases(20%) of pseudosacculations,42cases(70%) of mesenteric lymphadenopathy,4 cases of perianal lesion. CT findings of bowel wall thickening, mural stratification, mural hyperenhancement, mural abscess, perienteric phlegmon, and comb sign correlated with active inflammation. Compared with venous phase imaging, arterial phase imaging was noncontributory in all cases. The main findings of 23 cases who underwent SBFT included of skip lesions in 18 cases(78%), mucosal folds thickening in 22 cases(96%), linear ulcers in 17 cases(74%), cobblestones in 16 cases(70%).Conclusion:SBFT is sensitive in demonstrating the mucosal lesions of Crohn's disease such as linear ulcers and cobblestones, CTE proved to be sensitive in depicting mural abnormalities and significantly superior to SBFT in depicting Crohn's disease-associated extramural abnormalities. CTE can demonstrate lesions of the small intestine and the colon simultaneously, and it proved to have advantages in depicting mural abnormalities and evaluating extramural abnormalities and activity of Crohn's disease. STE should be the imaging method of first choice when Crohn's disease is suspected.