目的： 探讨CT能谱成像定量分析在小肠克罗恩病活动度评估中的价值。方法： 回顾性分析我院2015年8月至2016年9月行CT能谱成像检查,且经病理证实的小肠克罗恩病患者54例,将其分为活动期组（34例）和缓解期组（20例）,对其活动期与缓解期的肠壁动脉期（aterial phase,AP）及门脉期（portal phase,PP）标化碘浓度（normalized iodine concentration,nIc）、标化水浓度（normalized water concentration,nWc）、能谱曲线斜率进行比较,并计算和绘制上述有统计学差异的变量的受试者工作特征曲线。 结果： CT能谱成像中,小肠克罗恩病患者活动期肠壁AP及PP的nIc值分别为（0.228±0.100） g/L、（0.530±0.097） g/L,均高于缓解期[AP及PP的nIc分别为（0.097±0.045） g/L、（0.252±0.063） g/L]（P<0.05）;而活动期的肠壁PP的nWc值为（0.232±0.068） g/L,高于缓解期肠壁[（0.009±0.013） g/L]（P<0.05）;活动期的肠壁AP、PP能谱曲线的斜率分别为（2.749±1.051）和（3.638±0.724）,均高于缓解期[AP、PP分别为（1.069±0.467）和（1.653±0.687）]（P<0.05）;CT能谱成像AP、PP的nIc鉴别小肠克罗恩病活动期与缓解期的受试者工作特征曲线下面积值分别为0.965和0.998;PP的nWc鉴别二者的曲线下面积值为0.726;AP、PP的能谱曲线斜率鉴别二者的曲线下面积值分别为0.964和0.972。结论： CT能谱成像可以定量鉴别克罗恩病的活动期与缓解期,AP和PP的nIc值及能谱曲线斜率是两者鉴别中较优的参数。

Objective: To investigate the value of CT spectral imaging in evaluation of Crohn's disease activity. Methods: Fifty four patients with Crohn's disease undergone dual phase spectral CT imaging and confirmed by pathology in our hospital from Aug 2015 to Sep 2016 were enrolled. The normalized iodine concentration and normalized water concentration and the slope of spectral curve of bowel wall of arterial phase and portal venous phase at active stage and remission stage were analyzed by t test. And ROC curves of above mentioned variables with statistical difference were calculated and compared. Results: In CT spectral imaging, the arterial phase and portal venous phase normalized iodine concentration at active stage were higher than those at remission stage [(0.228±0.100) g/L vs. (0.097±0.045) g/L, P<0.05; （0.530±0.097） g/L vs. (0.252±0.063） g/L, P<0.05, respectively]. The portal venous phase normalized water concentration at active stage was higher than that of normal control [0.232±0.068） g/L vs. （0.009±0.013） g/L, P<0.05]. The arterial phase and portal venous phase slope of spectral curve at active stage were higher than those at remission stage [2.749±1.051 vs. 1.069±0.457; 3.638±0.724 vs. 1.653±0.687, respectively]. The AUC of arterial phase and portal venous phase normalized iodine concentration for differentiation of active and remission stages were 0.965 and 0.998, respectively; the AUC of portal venous phase normalized water concentration for differentiation of active and remission stage was 0.746 ; the AUC of arterial phase and portal venous phase slope of spectral curve for differentiation of active and remission stage were 0.964 and 0.972,respectively. Conclusions: CT spectral imaging can quantitatively differentiate active and remissive stage of Crohn's disease, and the arterial phase and portal venous phase normalized iodine concentration and the slope of spectral curve in both phases are valuable parameters for differentiation of active and remission stages.