Abstract:

Objective To investigate the characteristics of CT signs in ileocecal tuberculosis, cancer and lymphoma, and to improve the diagnosis and differential diagnosis of ileocecal diseases. Methods The data of 16 cases of ileocecal tuberculosis (tuberculosis group), 40 cases of ileocecal carcinoma (cancer group) and 14 cases of ileocecal lymphoma (lymphoma group) from the imaging database of Beijing Shijitan Hospital affiliated to Capital Medical University from February 2008 to September 2019 were retrospectively analyzed, and the CT features of the three groups of diseases were compared. Results (1) The intestinal length of ileocecal tuberculosis, cancer and lymphoma were (9.5±2.9) cm, (4.7±1.4) cm, and (9.0±2.7) cm respectively, and the differences of intestinal length were statistically significant (t=8.046, P=0.000; t=7.309, P=0.000).The thicknesses of diseased intestine in three groups were (1.6±0.3) cm, (2.3±0.7) cm, and (2.3±0.6) cm, and the differences of thickness of diseased intestine were statistically significant, between the tuberculosis group and the cancer group, the tuberculosis group and the lymphoma group (t=3.177, P=0.002; t=2.082, P=0.037).(2) The tuberculosis group and the lymphoma group mainly showed uniform thickening of the intestinal wall. The incidence rates of homogeneous thickening of the intestinal wall in the three groups were 62.5% (10/16), 22.5% (9/40) and 57.1% (8/14), and the differences were statistically significant between the tuberculosis group and the cancer group, the cancer group and the lymphoma group (χ ²=8.157, P=0.004; χ ²=5.770, P=0.016).The main manifestation of the cancer group was irregular lump-like lesions in the intestinal wall. The incidence rates of irregular thickening of the intestinal wall in the three groups were 37.5% (6/16), 77.5% (31/40) and 42.9% (6/14), and the differences were statistically significant between the tuberculosis group and the cancer group, the cancer group and the lymphoma group (χ ²=8.157, P=0.004; χ ²=5.770, P=0.016). The incidence rates of fuzzy boundary between healthy and pathologic intestinal canal were 87.5% (14/16), 30.0% (12/40) and 21.4% (3/14) respectively, and the differences were statistically significant (χ ²=15.190, P=0.000; Fisher P=0.001) between the tuberculosis group and the cancer group, the tuberculosis group and the lymphoma group. The incidence rates of mild misty mesentery were 25.0% (4/16), 77.5% (31/40) and 92.9% (13/14), and the differences were statistically significant between the tuberculosis group and the cancer group, the tuberculosis group and the lymphoma group (χ ²=13.440, P=0.000; Fisher P=0.000).The incidence rates of severe misty mesentery were 75.0% (12/16), 22.5% (9/40), 7.1% (1/14) respectively, and the differences were statistically significant between the tuberculosis group and the cancer group, the tuberculosis group and the lymphoma group (χ ²=13.440, P=0.000; Fisher P=0.000). Conclusion The length and thickness of the diseased intestine, the boundary between lesions and normal intestine, mild or severely turbidity of the mesentery, and other CT signs were different in ileocecal tuberculosis, cancer and lymphoma, and CT scans help clarify the diagnosis.

Key words: Ileal diseases, Cecal diseases, Tuberculosis, gastrointestinal, Ileal neoplasms, Tomography, X-ray computed, Disease attributes, Diagnosis, differential