Crohn disease - diagnostic imaging spectrum of the pathological changes and complications

Full text:The pathological changes in Crohn's disease are considered, classified and analyzed and the possibilities for its visualization by some image diagnostic methods are assessed. 25 patients with clinical and histological proven Crohn's disease, (17 men and 8 women, 75% of them between 20 and 40 years), for a period from 2006 to 2009, were examined and analyzed. A conventional controlled passage with barium sulfate for 24 hours in 25 patients has been used and in half of the patients a further contrast to the twelfth hour was given. In six patients the study was performed with multidetector CT (MDCT) by applying a water-soluble nonionic and ionic contrast media. Conventional tests were performed on digital multifunctional X-ray apparatus Iconos R200 (Siemens) and MDCT tests were performed on Light Speed 16 (GE). In six patients the both tests were performed. The following abnormal morphological changes have been determined: thickening and ulceration of the intestinal wall - 2 patients (8%); initial form of the disease; fistulizing of different parts of the gastrointestinal tract and other organ and systems in the abdomen - 3 patients (12%), permanent mail strictures - 20 patients (80%), 12 of which (48%) with single stricture with typical involvement of the terminal ileum, 5 patients (20%) with multiple structure, with typical involvement of the terminal ileum and the other segments and 3 patients (12%) with multiple strictures in level style. In Crohn's disease, there is a great diversity of morbid changes in gastrointestinal tract in terms of morphology and localization. MDCT has significant advantages over conventional study of gastrointestinal tract and it can be seen as a 'gold standard'