摘要
目的 利用剪切波弹性成像(SWE)定量评估肠壁硬度,探讨常规肠道超声(IUS)联合SWE在克罗恩病(CD)活动性评估中的应用价值。方法 纳入62例CD患者,记录年龄、性别、体重指数,均使用常规IUS及SWE测量最严重病变肠段的肠壁厚度(BWT)及杨氏模量弹性模量平均值(Emean),根据简化克罗恩病内镜下评分(SES-CD)将CD患者分为活动期和缓解期。比较CD活动期和缓解期的BWT和弹性模量值差异,计算常规IUS联合SWE诊断CD活动性的最佳截断值和诊断效能。结果 CD组活动期BWT及Emean高于缓解期,活动期的Limberg分级高于缓解期(P<0.05)。以Emean>12.65 kPa为截断值时,超声诊断CD活动性的敏感性和特异性分别为66.7%和85.7%;而联合使用IUS和SWE时,诊断CD活动性的敏感性和特异性分别为93.8%和87.5%。结论 常规IUS联合SWE可定量评估CD患者的肠壁硬度及厚度,对辅助评估CD活动性具有积极意义。
Objective To quantitatively evaluate intestinal wall hardness using shear wave elastography(SWE)and explore the application value of conventional intestinal ultrasound(IUS)combined with SWE in the assessment of Crohn’s disease(CD)activity.Methods A total of 62 patients with CD were included,and their age,gender,and body mass index were recorded.Conventional IUS and SWE were used to measure the bowel wall thickness(BWT)and Young’s modulus mean shear wave elasticity(Emean)of the most severely affected segment of the intestine.According to the results of the simplified endoscopic score for Crohn’s disease(SES-CD),CD patients were divided into active and remission phases.The differences in BWT and elastic modulus values between CD activity and remission periods were compared,and the optimal cut-off value and diagnostic efficacy of conventional IUS combined with SWE for diagnosing CD activity calculated.Results The BWT and Emean of the CD group during the active period were higher than those during the remission period,and the Limberg grading during the active period was higher than that during the remission period(P<0.05).The sensitivity and specificity of ultrasound in the diagnosis of CD activity were 66.7%and 85.7%when the cut-off value of Emean was>12.65 kPa,when IUS and SWE were used together,the sensitivity and specificity were 93.8%and 87.5%,respectively.Conclusion Conventional IUS combined with SWE can quantitatively assess bowel wall stiffness and thickness in patients with CD,and help improve diagnostic efficiency and predict CD activity.
作者
冉青
汤莹莹
喻红霞
甄艳华
RAN Qing;TANG Yingying;YU Hongxia;ZHEN Yanhua(Ultrasound Department,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)
出处
《河南医学研究》
CAS
2024年第20期3789-3794,共6页
Henan Medical Research
基金
河南省医学科技攻关计划联合共建项目(LHGJ20210377)。
关键词
常规肠道超声
剪切波弹性成像
克罗恩病
conventional intestinal ultrasound
shear wave elastography
Crohn’s disease
