摘要
目的探讨经腹壁肠道超声检查对于IBD诊断及评估病情的价值。方法本研究是一项前瞻性研究,以结肠镜或小肠镜检查作为金标准,选取2011年8月-2012年8月在本研究中心诊为炎症性肠病的患者35例,每位克罗恩病患者均行CDAI评分。超声肠壁厚度(BWT)≥4 mm诊断为病变肠段,用Limberg分级法半定量评估能量多普勒结果,Ⅰ、Ⅱ为缓解期,Ⅲ、Ⅳ为活动期。结果 23例克罗恩病患者内镜判断活动期20例、缓解期3例,CDAI评分<150分13例,150～450分10例,>450分0例。12例溃疡性结肠炎患者,内镜判断活动期9例、缓解期3例。35例患者均能获得满意的体表超声图像,缓解期肠段BWT平均为(2.08±0.49)mm,炎症活动期肠段平均BWT为(7.66±2.07)mm,差异具有统计学意义(P<0.05)。超声诊断溃疡性结肠炎符合率为83.3%;诊断克罗恩病符合率为91.3%,结合多普勒超声判断活动性,在克罗恩病中准确性达91.3%,UC中达100%。超声发现肠外表现:腹腔脓肿1例,腹腔淋巴结肿大8例,腹腔积液4例。结论经腹肠道超声对肠管壁的厚度、结构层次、回声情况及肠外并发症的观察具有优势,能准确评估炎症性肠病的活动性,在炎症性肠病的临床诊治过程中具有一定的指导意义。
Objective To evaluate the efficacy of ultrasonography （US） in the diagnosis and assessment of IBD ac- tivity. Methods 35 patients diagnosed as inflammatory bowel disease （IBD） from Aug. 2011 to Aug. 2012 in our cen- ter were selected in this prospective study. Crohn＇ s Disease Activity Index （CDAI） was calculated. Sonographic find- ings were compared with manifestations of colonoscopy （or enteroscopy） , used as the gold standard. Bowel wall thick- ness （BWT） ~〉4 mm was the criteria of inflamed segments. Bowel wall vascularity was semiquantitatively assessed with Limberg score, I and II as remissive, III and IV as active. Results 23 patients were Crohn＇ s disease （20 patients in endoscopic active phase, 3 patients in remissive phase; 13 cases of CDAI 〈 150, other 10 case of CDAI from 150 to 450）. 9 patients with active ulcerative colitis （UC） and 3 quiescent UC were also studied. Bowel wall thickness meas- ured on sonography in the patients with endoscopic activity was （7.66 ± 2.07） mm,it was significantly greater than that of patients in endoscopic remission （2.08 ±0.49）mm （P〈0.05）. The criteria of BWT≥4 mm 9l. 3% of CD and 83.3% of UC were diagnosed correctly. When combined with the grades of hyperemia measured with power Doppler, the accuracy of assessment of activity in CD and UC patients were 91.3% and 100% , respectively. US was also superi- or in finding of the perienteric changes. Conclusion US imaging enables noninvasive evaluation and monitoring the ac- tivity of inflammation in patients with IBD and is helpful for the management of IBD.
出处
《胃肠病学和肝病学杂志》
CAS
2013年第10期1013-1016,共4页
Chinese Journal of Gastroenterology and Hepatology
关键词
炎症性肠病
克罗恩病
溃疡性结肠炎
超声
结肠镜
Inflammatory bowel disease
Crohn＇ s disease
Ulcerative colitis
Uhrasonography
Colonoscopy
