| Objective: To study the imaging manifestations and spectral characteristics of intestinal inflammatory lesions after taking isotonic mannitol orally and checking by dual-source computed tomography enterography to evaluate the diagnostic value of the imaging method.Methods: As the study group,58 cases of complete data which were intestinal inflammatory lesions confirmed by clinical,endoscopic,or surgical pathology in our hospital during May 2014 to February 2016 were collected.There were 29 cases of Crohn's disease,19 cases of ulcerative colitis and 10 cases of intestinal tuberculosis.10 cases of clinically diagnosed patients without diseases of the digestive system were the normal group.All cases were examined by dual source CT enterography spectrum imaging and spectral imaging postprocessing.Four groups of imaging and spectral characteristics were observed.The imaging features contained lesion extent,the thickness of lesions,enhancement pattern and level,mesenteric lymph nodes and parenteral complications.The spectral characteristics included the slope of the curve shape and 40 ke V-100 ke V spectrum curve.The features were analyzed by chi square test,one way analysis of variance and LSD test.Results: 1.The favorite sites of Crohn's disease were ileal 93.1%(27/29),ileocecal valve 65.5%(19/29),jejunum 48.3%(14/29).The favorite sites of intestinal tuberculosis were ileocecal valve 80%(8/10),ileum 70%(7/10),right hemicolon 60%(6/10).Ulcer colitis involved total colectomy accounted for 47.4%(9/19),left hemicolon accounted for 36.8%(7/19),only the rectum accounted for 15.8%(3/19).2.The difference of the thickness of lesions among the three groups was statistically significant(P<0.05).There was no significant difference between Crohn's disease and intestinal tuberculosis group(P>0.05),and there were statistically significant differences between the other groups.Skip lesions,intestinal wall of mesentery thickening,pseudodiverticulum syndrome,the ileocecal valve block and comb signs had statistical difference among the three groups,which were useful to the diagnosis of Crohn's disease.Symmetry thickening,uniform enhancement,centipede syndrome and colonic pouch disappeared signs among the three groups had significant difference,which were useful to the diagnosis of ulcerative colitis.The ileocecal valve contracture,lymph nodes along the right colonic artery distribution,lymph nodes of central necrosis,ascites and pulmonary tuberculosis were statistically significant among the three groups which were useful to the diagnosis of intestinal tuberculosis.3.The slope were(1.439±0.453)vs(1.688±0.427)vs(1.695±0.247)vs(1.423±0.542)in plain scanning,(3.785±1.267)vs(2.958±0.697)vs(3.882±0.887)vs(2.145±0.645)in arterial phase,(4.998±1.242)vs(3.879±1.035)vs(5.069±1.169)vs(2.543±0.693)in portal phase,(3.923±1.104)vs(3.046±1.046)vs(4.047±1.264)vs(2.056±0.548)in delay phase among Crohn's disease,ulcerative colitis,intestinal tuberculosis and the normal group.The slope in plain scanning had no significant difference among the four groups.The order of slope from high to low was intestinal tuberculosis,Crohn's disease,ulcerative colitis and the normal group.There was no significant difference between Crohn's disease and intestinal tuberculosis group,and there were statistically significant differences between the other groups.Conclusion: 1.CTE can reflect the imaging features of Crohn's disease,ulcerative colitis,intestinal tuberculosis and the normal group.2.The spectrum curve and slope can help us distinguish intestinal tuberculosis,Crohn's disease,ulcerative colitis and the normal group,but its value is limited between Crohn's disease and intestinal tuberculosis.3.CTE combined with spectral imaging provide a new method and idea for the diagnosis and differential diagnosis of intestinal inflammatory lesions,and it has high value in clinical application.Objective: To study the imaging manifestations and spectral characteristics of activity and inactivity for Crohn's disease after taking isotonic mannitol orally and checking by dual-source computed tomography enterography to evaluate the diagnostic value of the imaging method.Methods: As the study group,29 cases of complete data which were Crohn's disease confirmed by clinical,endoscopic,or surgical pathology in our hospital during May 2014 to February 2016 were collected.There were 15 cases of activity for Crohn's disease and 14 cases of inactivity for Crohn's disease.All cases were examined by dual source CT enterography spectrum imaging and spectral imaging postprocessing.Four groups of imaging and spectral characteristics were observed.The imaging features contained the thickness of lesions,enhancement pattern and level,mesenteric lymph nodes and parenteral complications.The spectral characteristics included the slope of the curve shape and 40 ke V-100 ke V spectrum curve.The features were analyzed by chi square test and T test.Results: 1.Intestinal lumen stenosis,target sign,comb sign,swollen lymph nodes and phlegmon occurred more frequently in activity than inactivity for Crohn's disease.Pseudodiverticulum syndrome,stratification with submucosal fat deposition and uniform enhancement occurred more frequently in inactivity than activity for Crohn's disease.The thickness of bowel wall in activity and inactivity for Crohn's disease were 15.6±0.4mm and 5.9±0.6mm.There were statistically significant differences between the two groups.2.The slope were(1.526±0.446)vs(1.346±0.458)in plain scanning,(4.760±1.332)vs (2.980±0.576)in arterial phase,(6.081±0.667)vs(3.838±0.357)in portal phase,(4.539±0.712)vs(3.511±0.788)in delay phase between the two groups.The slope in plain scanning had no significant difference.The slope of active phase was higher than the slope of inactive phase in enhancement phase.There were statistically significant differences between the two groups.Conclusion: CTE combined with spectral imaging can help differentiate activity for Crohn's disease from inactivity for Crohn's disease.It is important to guide the clinical treatment. |
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