Study On The Value Of Computer Tomography Enterography And Magnetic Resonance Enterography Imaging In The Diagnosis Of Inflammatory Bowel Disease

Part one The value of Computer Tomography Enterography imaging in the diagnosis ofInflammatory Bowel DiseaseObjectives: To evaluate the clinical value of computed tomography enterography(CTE)and mesenteric vessel CT angiography(CTA)in the diagnosis of inflammatory bowel disease.Material and methods: the retrospetive analysis method.129 patients with inflammatory bowel disease were analysised from 2012 August to 2017 February in our hospital,with complete medical records.All the cases underwent Philips 256-slice CT scanner and use MPR after scans.Combined with clinical,endoscopy and pathological examination,to discuss the value of CTE in the diagnosis of inflammatory bowel disease.Results: of the 129 cases selected,IBD: 55 patients(which including 34 patients of CD and 21 patients of UC),ordinary enteritis: 32 patients,colinic polyps or gastrointestinal cancer: 10 patients,23 patients negative in endoscopy and imaging,poor bowel filling: 5 patients,imaging negative without endoscopy examination: 4 patients.Of the 55 cases of inflammatory bowel disease,in CTE findings,Crohn's diseases: 29 patients(the case detection rate is 85.3%),Ucerative colitis:16 patients(the case detection rate is 76.2%),ordinary enteritis: 22 patients(the case detection rate is 66.7%).For the Ucerative colitis in which the total lolon was affected,CTE and endoscopic diagnosis were corresponded 100% identical.Compared with the results of ordinary enteritis,CTE can show intestinal wall thickening,mural hyperenhancement(CT attenuation value),enlarged mesenteric lymph nodes,dilated vasa recta(comb sign)(p<0.05).Conclusion: CTE is useful for the differential diagnosis of inflammatory bowel disease and ordinary enteritis,and can clearly show intestinal and extra-enteric complications,play an important role in the diagnosis of the inflammatory bowel disease.Part two The value of Magnetic resonance enterography imaging in the diagnosis ofInflammatory Bowel DiseaseObjectives: To analyze the magnetic resonance enterography imaging findings in inflammatory bowel disease.to evaluate the value of magnetic resonance enterography in the diagnosis of inflammatory bowel disease.Material and methods: the retrospective analysis method.25 patients with inflammatory bowel disease were analyzed from 2016 January to 2017 January in our hospital,with complete medical records.All the cases underwent MRI plain scan and contrast enhancement.All did axial and coronal FSPGR T1 WI,FRFSE T2 WI,FIESTA and axial DWI.Then all use lava technology for enhanced MR examination.Compared with endoscopy,to discuss the sensitivity of MRE in the detective of lesions and accuracy of MRE in the diagnosis of inflammatory bowel disease.Results: of the 25 cases selected,combined with clinical,endoscopy and pathological examination,15 cases were diagnose as Crohn's diseases and 10 cases were diagnosed as ulcerative colitis.In 25 cases,2 cases were of poor bowel filling,1 case was poor breath-holding and the imaging was not clear,so almost 88% cases were successfully performed.12 cases of Crohn's diseases(12/15 cases,the detection rate was 80%)and 7cases of ulcerative colitis(7/10 cases,the detection rate was 70%)were detected by MRE.Magnetic resonance enterography imaging findings: intestinal wall thickening: 19 patients,mural hyperenhancement: 17 patients,enlarged mesenteric lymph nodes: 11 patients,stenosis 6 patients,dilated vasa recta(comb sign): 12 patients.Of 12 Crohn's diseases detected by MRE,10 cases affected distal ileum,2 cases affected both distal ileum and colon.In 19 cases detected by MRE,the surface diffusion coefficient(ADC value)of affected intestinal wall which was(1.45 ± 0.28)×10-3mm2/s,compared with normal intestinal wall,of which the ADC value was(2.23± 0.41)×10-3mm2/s,the difference was statistically significant(t=-10.32,P<0.01).Conclusion: Magnetic resonance enterography not only can clearly show the lesion of the intestinal wall and parenteral complications,but also has good sensitivity in detection of the lesions and can play an important role in the diagnosis of the inflammatory bowel disease.Part three Compare the value of Magnetic Resonance Enterography and Computer TomographyEnterography imaging in the diagnosis of Crohn's diseaseObjectives: To analyze the magnetic resonance enterography and computer tomography enterography imaging findings in Crohn's disease.To compare the value of magnetic resonance enterography with computer tomography enterography in the diagnosis of Crohn's disease.Material and methods: the retrospective analysis method.15 patients after clinical,colonoscopy and pathology diagnosis of Crohn's disease were analyzed from 2016 January to 2017 January in our hospital,with complete medical records.All the cases underwent MRI plain scan and contrast enhancement.All did axial and coronal FSPGR T1 WI,FRFSE T2 WI,FIESTA and axial DWI.Then all use lava technology for enhanced MR examination.34 patients with Crohn's disease were analyzed from 2012 August to 2017 February in our hospital,with complete medical records.All the cases underwent Philips 256-slice CT scanner and use MPR after scans.Analyze the imaging findings of Crohn's disease,including intestinal wall thickening,mural hyperenhancement,enlarged mesenteric lymph nodes,stenosis,dilated vasa recta(comb sign),abscess.Compare the sensitivity in the detective of lesions and accuracy in the diagnosis of Crohn's disease between MRE and CTE.Results: In 34 cases diagnosed by clinical,endoscopic,pathological information,29 cases of Crohn's diseases(detection rate was 85.3%)were detected by CTE.In 15 cases diagnosed by clinical,endoscopic,pathological information,12 cases of Crohn's diseases(detection rate was 80%)were detected by MRE,the difference was not statistically significant(P>0.05).Magnetic resonance enterography imaging findings: intestinal wall thickening: 12 patients,mural hyperenhancement: 11 patients,enlarged mesenteric lymph nodes: 8 patients,stenosis 4 patients,dilated vasa recta(comb sign): 7 patients.Of 12 Crohn's diseases detected by MRE,10 cases affected distal ileum,2 cases affected both distal ileum and colon.Computer tomography enterography imaging findings: intestinal wall thickening: 29 patients,mural hyperenhancement: 23 patients,enlarged mesenteric lymph nodes: 20 patients,stenosis: 9 patients,dilated vasa recta(comb sign): 19 patients,abscess: 2 patients.Of 29 Crohn's diseases detected by CTE,12 cases affected distal ileum,17 cases affected both distal ileum and colon.the difference was not statistically significant(P>0.05).In 22 cases detected by MRE,the surface diffusion coefficient(ADC value)of affected intestinal wall,compared with normal intestinal wall,the difference was statistically significant(t=-10.32,P<0.01).Conclusion: Both magnetic resonance enterography and CT enterography can clearly show the lesion of the intestinal wall and parenteral complications,and have similar sensitivity in detection of the lesions.But they have their own advantages and disadvantages,can be chosen based on individual characteristics.