克罗恩病CT、MRI诊疗方案.pptVIP

最内层为高密度的黏膜层，中间为低密度水肿的黏膜下层，最外层为高密度的浆膜层；增强后内层为强化的黏膜层，外层为低密度水肿的黏膜下层。慢性期溃疡进一步延伸至浆膜层，这一时期形成一种比较典型的克罗恩病症状改变一一非干酪样肉芽肿 * Figure 8.Stratified enhancement of bowel in a 53-year-old man with active Crohn disease. Coronal contrast-enhanced fat-suppressed T1-weighted 3D gradient- echo MR image shows stratified mural enhancement in a small-bowel loop (arrow). The hyperenhancing inflamed mucosa at the center is surrounded by a lower-signal-intensity ring of submucosal edema and an outer ring of enhancing serosa, creating a targetlike appearance at cross-sectional imaging. * Figure 9. Increased mesenteric vascularity (comb sign) due to acute inflammation in a 28-year-old man with active Crohn disease. Coronal contrast-enhanced fat-suppressed T1-weighted 3D gradient-echo image shows increased vascularity (arrow) adjacent to a hyperenhancing thickened segment of ileum (arrowhead). This patient’s condition improved with medical management. * * Figure 3. Crohn disease of the ileum and cecum in a 39-year-old woman. (a) Coronal single-shot fast spin-echo localizer MR image shows small-bowel wall thickening, submucosal edema, and surrounding fat accumulation (arrows). Dilated jejunum also is seen in the left side of the abdomen (arrowhead). An underlying bowel obstruction was successfully managed surgically. (b) Coronal SSFP image shows segmental bowel dilatation (arrow) and vascular detail within the small-bowel mesentery (arrowhead). * Figure 5. Utility of axial contrast-enhanced imagingin evaluating Crohn disease. Axial contrast-enhancedfat-suppressed T1-weighted 3D gradient-echoMR image obtained in a 28-year-old man shows two ileocolic fistulas (arrows) that were difficult to detecton coronal images. (b) Axial pelvic T2-weighted MR image depicts the rectal fistula (arrow) and an extensive fluid collection with gas in the presacral space (arrowheads). * Figure 12. Sinus tracts. (a) Coronal high-resolution true FISP MR image (3.8/1.6, 60° flip angle, 2-mm section thickness) shows sinu