关键词: 肺结核, 肠结核, 克罗恩病, 影像学诊断, 鉴别诊断

Abstract: Tuberculosis (TB) still has a relatively high incidence in the world, and it is a sever public health problem. China is one of eight countries that account for two-thirds of the global TB total, and the prevention and control of TB remains grim. Intestinal tuberculosis, secondary to tuberculosis, is the most common type of abdominal tuberculosis. About 85%-90% of intestinal tuberculosis is located in the ileocecal valve and its adjacent ileum and colon, and the other parts are ascending colon, jejunum, transverse colon, etc. Bowel tuberculosis has the disease slowly commonly, and can manifest abdominal pain, abdominal wrap, diarrhea and constipation. Imaging examination is of great value in the diagnosis of intestinal tuberculosis. In particular,abdominal CT scan have a important role in understanding the internal structure of intestinal lesions and the degree of intestinal wall infiltration. In addition, colon double contrast imaging and PET/CT examination has certain diagnostic ability, but it is rarely used in clinic.Plain CT scan of the abdomen showed that intestinal tuberculosis usually manifest annular thickening of the intestinal wall and narrowing of the intestinal lumen, which may show intestinal skipping changes. Contrasted CT scan showed obvious uniform enhancement of the intestinal wall of the lesion area, and stratified phenomenon, “target sign” and“double ring sign”. Crohn disease is an inflammatory disease of intestinal tract of unknown cause, and also occurs in ileum and right colon with segmental and skipping lesions. Imaging and fiber-colonscopy revealed that Crohn disease and intestinal tuberculosis were different from mucosal ulcers. Crohn disease was multiple linear ulcers crisscrossing and characterized by longitudinal ulcers, while intestinal tuberculosis was characterized by transverse, circumferent banded ulcers and stellate ulcers. It is difficult to distinguish Crohn disease from intestinal tuberculosis by pathological examination. No caseous lesions were observed in Crohn disease histopathology, while caseous lesions may occur in intestinal tuberculosis.

Key words: Pulmonary tuberculosis, Intestinal tuberculosis, Crohn disease, Imaging diagnosis, Differential diagnosis