目的

探讨口服等渗甘露醇溶液CT 小肠造影（CTE）诊断儿童白塞病胃肠道病变中的临床价值。

方法

选择2022年1月至2023年12月于首都儿科研究所附属儿童医院风湿免疫科确诊的24例儿童白塞病患儿为研究对象。所有患儿均接受CTE检查，包括肠道准备、口服2.5%等渗甘露醇溶液充盈肠道及CT 增强扫描。CTE 检查结果与腹部超声及胃肠镜检查结果进行对比分析。本研究经首都儿科研究所附属儿童医院伦理委员会批准（审批文号：SHERLLM2023039），所有患儿监护人签署临床研究知情同意书。

结果

①24例患儿中，CTE 和超声的白塞病检出阳性率分别为62.5%（15/24）和20.8%（5/24），并且差异有统计学意义（χ²=8.58，P＜0.001）。②胃镜及肠镜对24例患儿的白塞病检出阳性率均为45.8%（11/24），与CTE 检出阳性率率比较，差异无统计学意义（χ²=1.34，P=0.386）。③CTE检出的15例白塞病呈阳性患儿中，均合并胃和（或）肠壁增厚，而表现为动脉期强化、淋巴结肿大、静脉期分层强化、肠系膜血管炎、气液平面及肠管扩张者，则各为12、8、7、4、1及1例。

结论

口服等渗甘露醇溶液CTE 对儿童白塞病胃肠道病变具有较高的诊断价值，能清晰显示病变特征，可作为临床诊断和评估的重要手段。

Objective

To investigate the diagnostic value of oral isosmotic mannitol solution for CT enterography（CTE）in gastrointestinal lesions of pediatric Behçet's disease.

Methods

Children with Behçet's disease admitted to the Department of Rheumatology and Immunology at the Children's Hospital of Capital Institute of Pediatrics from January 2022 to December 2023 were selected as the study subjects.A total of 24 children underwent CTE after bowel preparation and oral administration of 2.5%isosmotic mannitol solution to distend the gastrointestinal tract.The findings，including gastrointestinal wall thickening，arterial phase mucosal enhancement，venous phase stratified enhancement，and extraintestinal lesions，were compared with the results of abdominal ultrasound and gastrointestinal endoscopy.This study was approved by the Ethics Committee of the Children's Hospital of Capital Institute of Pediatrics （Approval No.SHERLLM2023039），and informed consent was obtained from the guardians of all children.

Results

①The positive detection rates of CTE and ultrasound were 62.5%（15/24）and 20.8%（5/24），respectively，with a statistically significant difference （χ²=8.58，P ＜0.001）.②All 24 children underwent gastrointestinal endoscopy，with a positive detection rate of 45.8%（11/24）for both gastroscopy and colonoscopy，which was lower than that of CTE，but the difference was not statistically significant （χ²=1.34，P=0.386）.③In the 15 children with positive CTE findings，gastrointestinal wall thickening was the most common manifestation，followed by arterial phase enhancement（12 cases），lymphadenopathy（8 cases），venous phase stratified enhancement（7 cases），mesenteric vasculitis（4 cases），and the presence of air-fluid levels（1 case）and intestinal dilation（1 case）.

Conclusions

Oral isotonic mannitol solution CTE has high diagnostic value for gastrointestinal lesions in pediatric Behçet's disease，clearly displaying lesion characteristics and serving as an important tool for clinical diagnosis and evaluation.