CT evaluation of the colon: Inflammatory disease
CT evaluation of the colon: Inflammatory disease
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DOI：
10.1148/radiographics.20.2.g00mc15399
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发表时间：
2000-03-01
期刊：
影响因子：
5.5
通讯作者：
Fishman, EK
中科院分区：
文献类型：
--
作者：
Horton, KM;Corl, FM;Fishman, EK
计算机断层扫描（CT）是有价值的检测和表征的许多炎症条件的结肠。在CT中，扩张、增厚的阑尾提示阑尾炎。结肠周围1- 4cm的椭圆形脂肪性病变伴肠系膜周围炎症是诊断网膜阑尾炎的依据。憩室炎与其他结肠炎性病变的区别在于病变段是否存在憩室。在盲肠炎中，CT显示盲肠扩张和盲肠壁的周向增厚，其可能继发于水肿的低密度。在放射性结肠炎中，临床病史是提示诊断的关键，因为CT表现可能是非特异性的。受累节段的位置、肠壁增厚的程度和外观有助于鉴别克罗恩病和溃疡性结肠炎。在缺血性结肠炎中，CT典型地表现为周向对称的肠壁增厚伴皱襞增大。移植物抗宿主病的CT表现包括小肠和结肠壁增厚，这可能导致管腔狭窄和肠袢分离。在感染性结肠炎中，受影响的结肠的部位和厚度可能提示特定的微生物。伪膜性结肠炎的肠壁增厚程度通常大于除克罗恩病以外的任何其他结肠炎性疾病。
Computed tomography (CT) is valuable for detection and characterization of many inflammatory conditions of the colon. At CT, a dilated, thickened appendix is suggestive of appendicitis. A 1-4-cm, oval, fatty pericolic lesion with surrounding mesenteric inflammation is diagnostic of epiploic appendagitis, The key to distinguishing diverticulitis from other inflammatory conditions of the colon is the presence of diverticula in the involved segment. In typhlitis, CT demonstrates cecal distention and circumferential thickening of the cecal wall, which may have low attenuation secondary to edema, In radiation colitis, the clinical history is the key to suggesting the diagnosis because the CT findings can be nonspecific. The location of the involved segment and the extent and appearance of wall thickening may help distinguish Crohn disease and ulcerative colitis. In ischemic colitis, CT typically demonstrates circumferential, symmetric wall thickening with fold enlargement. CT findings of graft-versus-host disease include small bowel and colonic wall thickening, which may result in luminal narrowing and separation of bowel loops. In infectious colitis, the site and thickness of colon affected may suggest a specific organism. The amount of wall thickening in pseudomembranous colitis is typically greater than in any other inflammatory disease of the colon except Crohn disease.