克罗恩病的潜伏过程：断层扫描方法在诊断中的作用

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上消化道、回肠末端或结肠局部的克罗恩病是通过内镜检查和活检标本的组织学检查观察病变而诊断的。在小肠受累的情况下，内镜检查的价值不大，视频胶囊内镜检查有一些禁忌症，建议使用放射学技术，如多螺旋计算机断层扫描和/或磁共振肠成像来进行诊断。

这里描述的是一位临床表现轻微的克罗恩病患者，其小肠和直肠受累，通过使用影像放射学技术验证了其诊断。一名44岁的男子，有轻微腹痛和消化不良。检查显示，有吸收不良的间接迹象，粪便钙蛋白增加；内镜检查与组织学验证显示，有直肠炎的模式。经过计算机断层扫描和磁共振成像肠道造影，可以诊断出小肠的巨大病变，这是症状的基底。

这个临床病例显示了克罗恩病的非典型临床表现，包括空肠、回肠和直肠受累。由于患者没有特征性的主诉，并且由于内窥镜和形态学检查的结果信息量不足，CT和MRI等影像技术在诊断中起到了决定性的作用。

作者简介

Yuliya F. Shumskaya

The First Sechenov Moscow State Medical University (Sechenov University); Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Email: yu.shumskaia@npcmr.ru
ORCID iD: 0000-0002-8521-4045
俄罗斯联邦, Moscow; Moscow

Tamara S. Nefedova

The First Sechenov Moscow State Medical University (Sechenov University)

Email: prosto.toma.22@gmail.com
ORCID iD: 0000-0002-6718-8701
SPIN 代码: 3097-4977
俄罗斯联邦, Moscow

Dina A. Akhmedzyanova

The First Sechenov Moscow State Medical University (Sechenov University)

Email: dina_akhm@mail.ru
ORCID iD: 0000-0001-7705-9754
SPIN 代码: 6983-5991
俄罗斯联邦, Moscow

Ivan A. Blokhin

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Email: i.blokhin@npcmr.ru
ORCID iD: 0000-0002-2681-9378
SPIN 代码: 3306-1387
俄罗斯联邦, Moscow

Marina G. Mnatsakanyan

The First Sechenov Moscow State Medical University (Sechenov University)

编辑信件的主要联系方式.
Email: mnatsakanyan08@mail.ru
ORCID iD: 0000-0001-9337-7453
SPIN 代码: 2015-1822

MD, Dr. Sci. (Med.)

俄罗斯联邦, Moscow

参考

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补充文件

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1. JATS XML
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2. 图1。静脉造影法的腹腔多螺旋计算机断层扫描，轴向平面：a）肠腔明显变窄，肠壁增厚，造影剂活跃积聚（箭头）；b）壁不均匀增厚的小肠扩大线圈（箭头）；c）可看到肠腔扩张和变窄；此外，积极积累造影剂的肠粘膜引起注意（箭头）；d）小骨盆内积液的环间区域用红色标记。

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3. 图2。磁共振肠动描记法，轴向平面：箭头表示小肠的增厚区域。

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4. 图3。磁共振肠动描记法，冠位：箭头表示小肠壁长段的增厚区域。

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