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磁共振小肠造影在儿童小肠疾病诊治中的应用 被引量:4

Application of magnetic resonance enterography for diagnosis of small intestinal diseases in children
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摘要 目的探讨磁共振小肠造影(MRE)在儿童小肠疾病诊治中的应用价值。方法选择性分析2009年7月至2014年1月在浙江大学医学院附属儿童医院行MRE检查92例患儿,回顾性分析MRE的影像特点,结合最终临床诊断来探讨MRE的诊断价值。结果92例患儿(平均年龄9.1岁,其中男61例、女31例)完成MRE检查,耐受性好,无并发症。11例(12%)肠管充盈欠佳,部分肠管显示不清。阳性表现者共66例(72%)。30例克罗恩病患儿MRE均发现病变肠管,16例发现肠道外病变,29例结肠镜检查发现结肠病变,22例行胶囊内镜检查,发现病变20例。7例肠梗阻MRE均表现为肠管扩张,其中4例显示梗阻部位。5例小肠肿瘤患儿MRE均发现肿块。4例肠结核患儿中有1例MRE显示肿大淋巴结伴环形强化。9例嗜酸粒细胞性胃肠炎患儿MRE显示肠壁强化。MRE所示肠管异常主要为肠壁增厚及强化、肠腔狭窄、肠管扩张等。结论MRE检查安全、可靠,能很好地显示肠道病变的部位和范围,是评估累及小肠相关疾病有价值的方法之一,尤其适用于克罗恩病儿童。 Objective To explore the value of magnetic resonance enterography (MRE) for diagnosis of small intestinal diseases in children. Method A total of 92 children who received MRE from July 2009 to January 2014 were included into this study. The clinical value of MRE in children was evaluated by describing the image presentation of MRE based on clinical diagnosis. Result All the 92 cases (average age was nine year and one month, among whom 61 were boys, and 31 were girls) received MRE examination with good tolerance and had no complications. Eleven cases (12%) did not show good distension of small bowel loop during MRE and could not evaluate the bowel wall pathologies correctly. A total of 66 cases (72%) showed pathological MRE images. All patients with Crohn's disease showed pathological gut and 53% (16/30) showed extramural changes with MRE, 97% (29/30) showed colon lesions with colonoscopy, 73% (20/22) showed small intestine lesions with capsule endoscopy. All patients with intestinal obstruction (7 cases) showed abnormal gut distension, 4 of whom showed obstruction point. Five patients with small intestinal neoplasms showed the mass with MRE. One of the patients with intestinal tuberculosis showed enlarged lymph nodes with ring strengthening. Nine cases with eosinophilic gastroenteritis (75 % ) and 1 case of gastrointestinal bleeding showed increased contrast enhancement for small bowel. The main finding of MRE were abnormal wall thickening and enhancement, gut stricture, bowel expansion, etc. Conclusion MRE for children was safe and reliable. It can be a suitable method for determining the location and extent of gut for small intestinal diseases, especially suitable for Crohn's disease in children.
作者 楼金玕 赖灿 陈飞波 陈洁 Lou Jingan, Lai Can, Chen Feibo, Chen die. ( Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China)
出处 《中华儿科杂志》 CAS CSCD 北大核心 2016年第1期52-55,共4页 Chinese Journal of Pediatrics
关键词 磁共振成像 小肠 CROHN病 儿童 Magnetic resonance imaging Intestine, small Crohn disease Child
作者简介 通信作者:陈洁,Email:hzcjie@zju.edu.cn
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