MSCT Evaluation In Crohn's Disease Of Small Bowel

ABSTRACTObjective To assess the value of enhanced multi—slice CT (MSCT) scan for the Crohn's disease of small bowel.Materials and Methods Fourty-five patients of small bowel Crohn's Disease who were proved by multi-method were examined by two-phase enhanced scan with MSCT.The images were reformed in ADW4.2(Advantage workstation 4.2).To compare the density of abnormal small bowel wall in different phases and the density between abnormal and normal small bowel wall in same phase,to compare MSCT and endoscopy,transect images and MPR images in all cases,and analyse generally the CT foundings.Results In 45 cases,38(84.4%) patients with skip lesions,44(97.8%) patients involved ileum,40(88.9%) patients involved the terminal ileum,the 'bowel wall thickening and increased enhancement were seen in all cases,30(66.7%) patients with mesentery abnormalities,36(80%) patients with swelled lymph nodes,7 cases with complications,which includes 5 cases with intestinal obstruction,1 case with abdominal abscess,1 case with intestinal fistula,and there were 21(46.7%) patients accompanied extra-intestinal manifestations in abdomen.In all cases,34 patients were examed by endoscopy,25 patients were positive,the detectable rate is 73.5%, while the detectable rate of MSCT is 100%;After enhancement,the lesion segments of small bowel enhanced highly,and there were obvious difference in density between the lesion segments and normal segments;MPR images can display lesions directly,and supplied transect images.Conclusion MSCT is an excellent modality of depicting the Crohn's disease of small bowel,Two-phase enhancement scan can make lesions display clearly,so raised highly the detectable rate,it also can assess the activity of lesions,bowel wall thickening,complications,mesentery abnormalities,and meanwhile display extra-intestinal manifestations in abdomen,MSCT make up the defects of endoscopy.MPR images is the important supplement to transect images,but transect images is still the base of diagnosis.The CT foundings of small bowel crohn's Disease lack of specialty,so the diagnostic accuracy of MSCT is not high,and it is not sensitive to the early lesions. MSCT can examed the whole small bowel,no blind area,no pain,no taboo,rapidness and low cost,it is a practical and impoatant exam to the Crohn's disease of small bowel.