目的 观察炎症性肠病（Inflammatory Bowel Disease，IBD）的能谱CT小肠造影（Energy Spectral CT Enterography， ECTE）表现，分析ECTE对IBD的诊断价值。方法 选取安徽医科大学附属六安医院2020年5月至2022年4月收治的临床疑似 IBD病例并顺利完成ECTE检查的105例患者，与最终临床诊断IBD相比，分析ECTE检查诊断IBD的敏感性、特异性及诊断 符合率，通过对IBD患者图像的能谱分析（最佳单能量图像、物质分离、能谱曲线）探讨ECTE对IBD的诊断价值，并对比 分析溃疡性结肠炎（Ulcerative colitis，UC）及克罗恩病（Crohn’s Disease，CD）的碘基值、能谱曲线斜率及影像特征。 结果 105例疑似IBD患者中，ECTE诊断IBD 42例，最终临床诊断IBD 47例，ECTE诊断IBD诊断的敏感性89.4%、特异性 100.0%、诊断符合率95.7%。IBD患者的能谱CT影像可见异常肠壁明显强化，部分肠壁呈分层样强化，偶可见管腔狭窄， 肠系膜血管“梳齿征”改变。可降低keV调整到符合诊断需求的单能量图像，经对比分析最佳单能量值为（50.36±4.47）keV； IBD患者异常肠壁处的动脉期、静脉期碘浓度与邻近正常肠壁相比，差异均具有统计学意义（P<0.05），且异常强化的肠 壁与正常强化的肠壁能谱曲线斜率差异具有统计学意义（P<0.05）。结论 ECTE 能清晰显示及分析IBD病灶，为IBD诊断提 供更有效的方式，对IBD有较高诊断价值。

Objective To observe the manifestations of energy spectral CT enterography (ECTE) of inflammatory bowel disease (IBD), and to analyze the application value of ECTE in IBD. Methods A total of 105 patients with suspected IBD and successfully completed ECTE examination in Lu’an Hospital of Anhui Medical University from May 2020 to April 2022 were selected. Compared with the final clinical diagnosis of IBD, the sensitivity, specificity and diagnostic coincidence rate of ECTE in the diagnosis of IBD were analyzed. The application value of ECTE in IBD was investigated by energy spectral analysis (best single energy image, material separation, energy spectral curve) of images of patients with IBD, and the iodine base value, energy spectral curve slope and imaging characteristics of ulcerative colitis (UC) and Crohn’s disease (CD) were compared and analyzed. Results Among the 105 suspected IBD patients, 42 cases were diagnosed as IBD by ECTE, and 47 cases were finally diagnosed as IBD by clinical diagnosis. The sensitivity of ECTE in the diagnosis of IBD was 89.4%, the specificity was 100.0%, and the diagnostic coincidence rate was 95.7%. The abnormal bowel wall in IBD patients was markedly enhanced, and part of the bowel wall showed stratified enhancement. Occasionally, lumen stenosis and the “comb sign” of mesenteric vessels could be seen. The keV could be reduced to adjust to a single energy image that met the diagnostic needs, and the best single energy value was (50.36±4.47) keV with comparative analysis; The differences between the arterial phase and venous phase iodine concentrations in the abnormal intestinal wall of IBD patients and the adjacent normal intestinal wall were statistically significant (P<0.05). There was a statistically significant difference in the slope of the energy spectral curve between the abnormally enhanced intestinal wall and the normal enhanced intestinal wall. Conclusion ECTE can clearly display and analyze IBD lesions, provide more effective ways for IBD diagnosis, and has a high diagnostic value for IBD.