目的 分析炎症性肠病多层螺旋 CT小肠增强造影影像学特点及与常规结 肠镜检查结果对比。方法 本研究观察对 象选择我院经病理诊断确诊的138例IBD患 者，其中克罗恩病98例，溃疡性结肠炎 40例，回顾性分析所有患者MSCTE影像学 以及结肠镜检查资料，分析MSCTE影像学 特点并与结肠镜检查结果进行比较。结 果 CD患者MSCTE检查肠腔狭窄、多节段性 病变、肠周脂肪间隙模糊、肠系膜血管增 生以及瘘管形成或腹腔脓肿人数比例显著 高于UC患者，结肠带消失显著低于UC患 者，差异具有统计学意义(P<0.05)，肠壁 强化、肠壁增厚、肠周淋巴结增多差异无 统计学意义(P>0.05)；MSCTE能诊断IBD结 肠带消失等肠外病变、肠壁增厚以及肠壁 强化，结肠镜无法诊断，差异具有统计学 意义(P<0.05)，结肠镜能诊断IBD卵石征 与肠壁溃疡，MSCTE不能，差异具有统计 学意义(P<0.05)，MSCTE诊断多节段病变 敏感性显著高于结肠镜，多发炎性息肉敏 感性显著低于结肠镜，差异具有统计学意 义(P<0.05)，肠腔狭窄均有较高的诊断效 能，诊断敏感性、特异度差异无统计学 意义(P>0.05)。结论 MSCTE能更好诊断 IBD，优势在于肠外病变、肠壁增厚以及 肠壁强化，以及对多节段病变诊断敏感性 较高，结肠镜能更好诊断卵石征、肠壁溃 疡以及多发炎性息肉。

Objective To investigate imaging features of multi—slice computer tomography enterography(MSCTE) in the diagnosis of inflammatory bowel disease (IBD), and to compare with the results of the conventional colonoscopy. Methods In this study, 138 IBD patients diagnosed by pathology in our hospital were selected, among them, 98 cases were Crohn's disease (CD), and 40 cases were ulcerative colitis (UC). The MSCTE and colonoscopy imaging data of all patients were retrospectively analyzed. The features of MSCTE were analyzed and compared with those of colonoscopy. Results The MSCTE imaging showed that the incidence rate of stenosis of enteric cavity, multi-segmental lesions, density increase of mesentery, proliferation of mesenteric vascular bundle, fistula formation, sinus in CD patients were higher than those in the UC patients, while the proportion of disappearance of the colonic bands among CD patients was lower than that in the UC patients (P<0.05), no difference was found in the incidence rate of the enhancement of intestinal wall, thickeness of intestinal wall and increasing peri enteric lymph node between groups (P>0.05). MSCTE could diagnose parenchymal lesions such as disappearance of IBD colon band, thickening of bowel wall and enhancement of bowel wall, which could not be diagnosed by colonoscopy, the difference was statistically significant (P<0.05). Colonoscopy could diagnosed IBD sclera and intestinal wall ulcer, which could not be diagnosed by MSCTE, the difference was statistically significant (P<0.05). The sensitivity of MSCTE for diagnosing multisegmental lesions was significantly higher than that of colonoscopy, while colonoscopy had a higher sensitivity in diagnosing multiple polyps, the difference was statistically significant (P<0.05). The sensitivity and specificity of the diagnosis of intestinal stricture was not statistically significant (P>0.05). Conclusion MSCTE has advantages in demonstrating intestinal wall thickening, enhancement of intestinal wall and extraintestinal complications of IBD, while colonoscopy is easy to demonstrate the IBD sclera and intestinal wall ulcer.