發(fā)布時(shí)間：2018-03-21 02:41

  本文選題：克羅恩病　切入點(diǎn)：腸結(jié)核　出處：《南昌大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討CT小腸造影檢查用于鑒別診斷克羅恩病和腸結(jié)核的可行性，并探討其鑒別診斷價(jià)值。 方法：回顧性分析2011年8月至2012年7月在南昌大學(xué)一附醫(yī)院消化科住院并經(jīng)過(guò)隨訪確診為克羅恩病及腸結(jié)核患者的CT小腸造影（CTE）影像資料，由2名副高以上職稱的胃腸影像學(xué)醫(yī)師盲法閱片并對(duì)其CT征象進(jìn)行系統(tǒng)分析，對(duì)其中有小腸累及的患者(克羅恩病及腸結(jié)核各19例）的影像征象進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果：克羅恩病患者中受累腸壁分層強(qiáng)化、腸壁不對(duì)稱性增厚、病灶呈多節(jié)段跳躍性、纖維脂肪增生、直小血管充血等五個(gè)指標(biāo)更為常見(jiàn)。而在腸結(jié)核患者中較多表現(xiàn)為腸壁不均勻性強(qiáng)化、腸壁對(duì)稱性增厚、淋巴結(jié)環(huán)形強(qiáng)化等三個(gè)指標(biāo)。將每個(gè)支持克羅恩病的影像指標(biāo)設(shè)置為+1分，而支持腸結(jié)核的則為-1分，依此計(jì)算每一患者的影像特征總分值。然后進(jìn)一步繪制依據(jù)上述影像特征總分值鑒別克羅恩病和腸結(jié)核的ROC曲線，分析得出鑒別的最佳臨界值為1.5，提示若八個(gè)影像分值總和＞1.5診斷為克羅恩病，反之則為腸結(jié)核。利用此方法進(jìn)行診斷，38人中有34人診斷正確，總符合率為89.5%，，4人診斷錯(cuò)誤，誤診率為10.5%。 結(jié)論：利用CT小腸造影檢查的影像征象進(jìn)行系統(tǒng)分析的方法對(duì)診斷和鑒別診斷克羅恩病與腸結(jié)核具有一定的臨床價(jià)值。
[Abstract]:Objective: to investigate the feasibility and value of CT enterography in differential diagnosis of Crohn's disease and intestinal tuberculosis. Methods: the CT enterography (CTE) images of patients with Crohn's disease and intestinal tuberculosis were analyzed retrospectively from August 2011 to July 2012 in the Department of Digestive Diseases of the affiliated Hospital of Nanchang University. The CT findings of 2 gastrointestinal imaging physicians with subtropical high professional titles and above were analyzed systematically. The imaging features of the patients with small bowel involvement (19 cases of Crohn's disease and 19 cases of intestinal tuberculosis) were analyzed statistically. Results: in the patients with Crohn's disease, the involved intestinal wall was enhanced by stratification, the intestinal wall was asymmetrically thickened, the lesion was multisegmental jump, and the fibrous fat was hyperplastic. It is more common in patients with intestinal tuberculosis than in patients with intestinal tuberculosis, but it is characterized by uneven enhancement of intestinal wall and symmetrical thickening of intestinal wall. Three indicators, including circular enhancement of lymph nodes, were set to 1 for each image supporting Crohn's disease, and -1 for those supporting intestinal tuberculosis. Based on this, the total score of the imaging features of each patient was calculated. Then the ROC curve was further drawn to distinguish Crohn's disease from intestinal tuberculosis based on the total score of the above image features. The results showed that the best critical value for differential diagnosis was 1.5, suggesting that if the sum of the eight imaging scores > 1.5 was diagnosed as Crohn's disease, otherwise it was intestinal tuberculosis. 34 out of 38 patients were diagnosed correctly by this method, and the total coincidence rate was 89.55.The total coincidence rate was 89.5%. The misdiagnosis rate was 10.5%. Conclusion: the method of systematic analysis of CT small bowel imaging findings has certain clinical value in the diagnosis and differential diagnosis of Crohn's disease and intestinal tuberculosis.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R816.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 鄭楠楠;胡道予;邵劍波;閆學(xué)強(qiáng);方磊;陳亮;;腸系膜上動(dòng)脈MSCTA對(duì)小腸疾病的診斷價(jià)值[J];臨床放射學(xué)雜志;2012年11期

2 朱林林;王一平;;CTE、CE、SBFT、MRE對(duì)小腸克羅恩病的診斷性系統(tǒng)評(píng)價(jià)[J];解放軍醫(yī)學(xué)雜志;2011年08期

3 朱希松;章士正;毛明香;;多層螺旋CT小腸造影對(duì)Crohn病的診斷價(jià)值評(píng)價(jià)[J];醫(yī)學(xué)影像學(xué)雜志;2011年06期

4 斯洋;潘杰;黃崇權(quán);洪瑞鎮(zhèn);;MSCT小腸造影與雙氣囊小腸鏡在小腸疾病診斷中的價(jià)值[J];放射學(xué)實(shí)踐;2011年03期

5 畢文杰;朱峰;李慎江;陳克敏;;口服甘露醇MSCTE診斷常見(jiàn)小腸腫瘤的臨床研究[J];放射學(xué)實(shí)踐;2010年01期

6 史濟(jì)華;劉煒;陸星華;潘衛(wèi)東;王l

本文編號(hào)：1641902