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目的前瞻性比较成年与儿童Crohn病病人的小肠病变累及部位和活动性的不同。方法 43例儿童(平均年龄15岁)和43例成人(平均年龄48岁)确诊Crohn病的病人进行MR肠道成像检查,以确定病变部位和小肠及大肠9个节段的活动性。对每例病人的每个节段结果进行分析。所有病人均进行了回结肠镜检查。以P<0.05为差异具有统计学意义。结果末端回肠的受累率在两组人群中明显不同:成人为100%(43/43),而儿童为58%(23/43)(P<0.0001)。相反,结肠的受累率在儿童为84%,而在成人为64%。特别是左半结肠在儿童更易受累(降结肠分别为53%与21%,P<0.01;直肠67%与23%,P<0.0001;乙状结肠为56%与37%,无统计学意义),盲肠的受累率在两组人群中大致相等。儿童病变活动性最高的部位是左半结肠,而成人则位于末端回肠。结论 MR肠道成像显示两组人群的表现明显不同,儿童病人中左半结肠的病变更广泛且严重,而成人则以末端回肠为著。
Objective To prospectively compare the lesion involvement and activity of small intestine in Crohn’s disease in adults and children. Methods Forty-three children (mean age 15 years) and 43 adults (mean age 48 years) with Crohn’s disease were examined by MR imaging to determine the location of the lesion, the activities of the 9 segments of the small intestine and the large intestine. The results for each segment of each patient were analyzed. All patients underwent colonoscopy. P <0.05 for the difference was statistically significant. Results The rate of end-ileal invasion was significantly different between the two groups: 100% (43/43) in adults and 58% (23/43) in children (P <0.0001). In contrast, colon involvement rates were 84% in children and 64% in adults. In particular, the left half colon was more susceptible to child involvement (53% vs 21% in the descending colon, P <0.01; 67% vs 23% in the rectum, P <0.0001; sigmoid colon was 56% vs 37%, not statistically significant) The prevalence was roughly equal between the two groups. The most active site of childhood disease is the left colon, while the adult is located in the distal ileum. Conclusions MR imaging of the bowel showed a markedly different performance in both groups of patients, with a more extensive and severe lesion in the left half of the colon in children and in the adult as the distal ileum.