Crohn病小腸病変に対するCT enterography

Using CT Enterograpy to Evaluate Small Bowel Disease Complicating Crohn's Disease

要旨　MPRを用いたMSCT，CT enterography，CT enteroclysisは，アフタ性潰瘍の初期病変などは評価できないものの，Crohn病小腸病変における腸間膜側の炎症，腹腔内膿瘍，狭窄，大量出血，リンパ節腫大，腸管腸管瘻を含む瘻孔病変の評価を非侵襲的に簡便に評価することにおいて優れている．（1）腸管合併症を有するCrohn病患者として，回腸末端部から出血を繰り返す小腸大腸型Crohn病の32歳女性，（2）再燃時に広範な縦走潰瘍に伴う小腸狭窄と腹腔内膿瘍を認めた34歳男性，（3）小腸部分切除後に小腸多発狭窄を認めた39歳男性の症例を提示した．MPRを用いたMSCT，CT enterography，CT enteroclysisは，非侵襲的に大量の容量データを獲得し，Crohn病の腸管合併症においても非侵襲的かつ簡便に病変を評価可能である．

　CT enteroclysis and CT enterography are methods of examining the small bowel using Multislice CT. We have encountered three cases of complications with stenosis of the intestine, abdominal abscess, and bleeding of the intestine with hypovolemic shock in Crohn's disease. The MPR technique is useful for diagnosing such complications. CT enterography and CT enteroclysis improve the ability to investigate small bowel disease, using MSCT with preparations of enteral material. Distension of the small bowel disturbs the findings of small bowel disease in Crohn's disease. New modalities have appeared for investigating diseases of the small bowel, for example capsule endoscopy, small bowel barium study, small bowel endoscopy and CT enterography. CT is superior in demonstrating mesenteric inflammation, abscesses, fistula of the intestine and other organs, and lymph nodes. The MPR technique with CT enteroclysis, CT enterography, and MSCT is a useful and non-invasive method for the evaluation of intestinal complications of Crohn's disease.