Clinical and MSCT Features of Crohn Disease and Intestinal Tuberculosis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZENGHan-jiang ¹ , ZHANGXiao ² , XUZhong-zi ¹ , HUANGZi-xing ¹ , ZHANGLi-zhi ¹ , CHENDong-dong ¹ , LUOYi ¹ , LIXue-ming ¹ ,  YUJian-qun ¹

1. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;
2. Department of CT/MRI, Leshan People's Hospital, Leshan 614000, Sichuan Province, China;

Corresponding author：

YUJian-qun, Email: cjr.yujianqun@vip.163.com

Keywords：

Crohn disease; Intestinal tuberculosis; Multislice CT; Clinical feature

DOI：

10.7507/1007-9424.20140217

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To compare Crohn disease(CD) with intestinal tuberculosis(ITB) in clinical and multislice CT(MSCT) features that may be helpful for the differential diagnosis. Methods Thirty-eight patients with CD and 13 with ITB proved surgically and pathologically were recruited for this study. The clinical symptoms, laboratory, and MSCT findings in these patients were retrospectively analyzed. Results The MSCT changes helpful in distinguishing CD from ITB included:①CD presented symmetrical intestinal wall thickening in most cases, while ITB were asymmetric (P < 0.05).②The irregular stricture was more common usually shown in CD groups, while coaxial in ITB(P < 0.05).③The lymphadenopathy with obvious enhancement and tortuously mesenteric vessels were frequently found in ITB group (P < 0.05). The clinical features of CD including abdominal pain, diarrhea, fever, anemia, hematochezia, weight loss, and intestinal complications were similar with ITB, and similar results were detected in the laboratory examination including the acceleration of erythrocyte sedimentation rate, postive C-reactive protein, and the reduction of albumin. The feature of hematochezia was more common in CD than in ITB, while concomitant pulmonary tuberculosis was more revealed in ITB(P < 0.05). Conclusions The MSCT findings of CD and ITB are characteristic. Combined with the similar clinical and laboratory features, the features of MSCT maybe helpful for definitive diagnosis.

Citation： ZENGHan-jiang, ZHANGXiao, XUZhong-zi, HUANGZi-xing, ZHANGLi-zhi, CHENDong-dong, LUOYi, LIXue-ming, YUJian-qun. Clinical and MSCT Features of Crohn Disease and Intestinal Tuberculosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(7): 900-904. doi: 10.7507/1007-9424.20140217 Copy

1.	刘小伟, 李学锋, 邹益友, 等. Logistic回归分析对克罗恩病和肠结核鉴别指标的筛选[J].世界华人消化杂志, 2010, 18(6): 621-627.
2.	Pulimood AB, Amarapurkar DN, Ghoshal U, et al. Differentiation of Crohn's disease from intestinal tuberculosis in India in 2010[J]. World J Gastroenterol, 2011, 17(4):433-443.
3.	Zhou ZY, Luo HS. Differential diagnosis between Crohn's disease and intestinal tuberculosis in China[J]. Int J Clin Pract, 2006, 60(2):212-214.
4.	Kirsch R, Pentecost M, Hall Pde M, et al. Role of colonoscopic biopsy in distinguishing between Crohn's disease and intestinal tuberculosis[J]. J Clin Pathol, 2006, 59(8):840-844.
5.	Dutta AK, Sahu MK, Gangadharan SK, et al. Distinguishing Crohn's disease from intestinal tuberculosis-a prospective study[J]. Trop Gastroenterol, 2011, 32(3):204-209.
6.	Zhao XS, Wang ZT, Wu ZY. Differentiation of Crohn's disease from intestinal tuberculosis by clinical and CT enterographic models[J]. Inflamm Bowel Dis, 2014, 20(5):916-925.
7.	Kirsch R, Pentecost M, Hall Pde M, et al. Role of colonoscopic biopsy in distinguishing between Crohn's disease and intestinal tuberculosis[J]. J Clin Pathol, 2006, 59(8):840-844.
8.	Li X, Liu X, Zou Y, et al. Predictors of clinical and endoscopic fi ndings in differentiating Crohn's disease from intestinal tuberculosis[J]. Dig Dis Sci, 2011, 56(1):188-196.
9.	曾锐, 欧阳钦, 胡锦梁.肠结核和克罗恩病临床病理改变的比较[J].现代预防医学, 2006, 33(12):2287-2294.
10.	梁矿立, 袁吉欣.肠结核的影像学诊断分析[J].中国现代医药杂志, 2011, 13(8):90-91.
11.	龚红霞, 许建荣.克罗恩病CT诊断进展[J].国外医学临床放射学分册, 2005, 28(1):42-46.
12.	王成龙, 伍兵.小肠克罗恩病的CT和MRI研究进展[J].华西医学, 2011, 26(1):133-135.
13.	Wills JS, Lobis IF, Denstman FJ. Crohn disease:state of the art[J]. Radiology, 1997, 202(3):597-610.
14.	Makanjuola D. Is it Crohn's disease or intestinal tuberculosis? CT analysis[J]. Eur J Radiol, 1998, 28(1):55-61.
15.	Nagi B, Kochhar R, Bhasin DK, et al. Colorectal tuberculosis[J]. Eur Radiol, 2003, 13(8):1907-1912.
16.	Almadi MA, Ghosh S, Aljebreen AM. Differentiating intestinal tuberculosis from Crohn's disease:a diagnostic challenge[J]. Am J Gastroenterol, 2009, 104(4):1003-1012.

1. 刘小伟, 李学锋, 邹益友, 等. Logistic回归分析对克罗恩病和肠结核鉴别指标的筛选[J].世界华人消化杂志, 2010, 18(6): 621-627.
2. Pulimood AB, Amarapurkar DN, Ghoshal U, et al. Differentiation of Crohn's disease from intestinal tuberculosis in India in 2010[J]. World J Gastroenterol, 2011, 17(4):433-443.
3. Zhou ZY, Luo HS. Differential diagnosis between Crohn's disease and intestinal tuberculosis in China[J]. Int J Clin Pract, 2006, 60(2):212-214.
4. Kirsch R, Pentecost M, Hall Pde M, et al. Role of colonoscopic biopsy in distinguishing between Crohn's disease and intestinal tuberculosis[J]. J Clin Pathol, 2006, 59(8):840-844.
5. Dutta AK, Sahu MK, Gangadharan SK, et al. Distinguishing Crohn's disease from intestinal tuberculosis-a prospective study[J]. Trop Gastroenterol, 2011, 32(3):204-209.
6. Zhao XS, Wang ZT, Wu ZY. Differentiation of Crohn's disease from intestinal tuberculosis by clinical and CT enterographic models[J]. Inflamm Bowel Dis, 2014, 20(5):916-925.
7. Kirsch R, Pentecost M, Hall Pde M, et al. Role of colonoscopic biopsy in distinguishing between Crohn's disease and intestinal tuberculosis[J]. J Clin Pathol, 2006, 59(8):840-844.
8. Li X, Liu X, Zou Y, et al. Predictors of clinical and endoscopic fi ndings in differentiating Crohn's disease from intestinal tuberculosis[J]. Dig Dis Sci, 2011, 56(1):188-196.
9. 曾锐, 欧阳钦, 胡锦梁.肠结核和克罗恩病临床病理改变的比较[J].现代预防医学, 2006, 33(12):2287-2294.
10. 梁矿立, 袁吉欣.肠结核的影像学诊断分析[J].中国现代医药杂志, 2011, 13(8):90-91.
11. 龚红霞, 许建荣.克罗恩病CT诊断进展[J].国外医学临床放射学分册, 2005, 28(1):42-46.
12. 王成龙, 伍兵.小肠克罗恩病的CT和MRI研究进展[J].华西医学, 2011, 26(1):133-135.
13. Wills JS, Lobis IF, Denstman FJ. Crohn disease:state of the art[J]. Radiology, 1997, 202(3):597-610.
14. Makanjuola D. Is it Crohn's disease or intestinal tuberculosis? CT analysis[J]. Eur J Radiol, 1998, 28(1):55-61.
15. Nagi B, Kochhar R, Bhasin DK, et al. Colorectal tuberculosis[J]. Eur Radiol, 2003, 13(8):1907-1912.
16. Almadi MA, Ghosh S, Aljebreen AM. Differentiating intestinal tuberculosis from Crohn's disease:a diagnostic challenge[J]. Am J Gastroenterol, 2009, 104(4):1003-1012.

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Clinical and MSCT Features of Crohn Disease and Intestinal Tuberculosis

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