摘要
目的:探究腹部超声在炎症性肠病(IBD)患儿诊断及治疗后活动性评估中的应用价值。方法:选择2021年1月—2023年1月于江西省儿童医院就诊的82例疑似IBD患儿,以结肠镜检查及组织活检结果为金标准,最终77例确诊IBD(纳入IBD组),其中克罗恩病(CD)37例(纳入CD组)、溃疡性结肠炎40例(纳入UC组);另选择于本院体检的50例健康儿童纳入健康组。计算腹部超声诊断IBD的敏感度、特异度、准确率;比较IBD组、健康组的肠壁厚度、动脉阻力指数(RI)及血流状态;比较CD组和UC组的超声检查图像指标、病变定位符合率及活动期和缓解期的肠壁厚度、动脉RI及血流状态。结果:腹部超声诊断IBD的敏感度、特异度、准确率分别为92.21%、60.00%、90.24%;IBD组肠壁厚度高于健康组,动脉RI低于健康组,血流分级差于健康组(P<0.05);CD组正常结构消失、肠间淋巴结肿大、肠间积液、炎性包块发生率均高于UC组(P<0.05);CD组超声诊断病变定位符合率为94.59%,UC组超声诊断病变定位符合率为90.00%;活动期、缓解期,CD组肠壁厚度均高于UC组,差异均有统计学意义(P<0.05);活动期,两组肠壁厚度高于缓解期,动脉RI低于缓解期,差异均有统计学意义(P<0.05)。缓解期,两组肠壁血流分级情况优于活动期,差异有统计学意义(P<0.05);活动期、缓解期,两组肠壁血流分级情况比较,差异均有统计学意义(P<0.05)。肠壁厚度、动脉RI诊断CD活动期的AUC分别为0.790、0.741,诊断UC活动期的AUC分别0.668、0.714。结论:腹部超声对IBD具有较高诊断价值,能够相对准确地定位病变位置,减少误诊,且可预判患儿治疗后活动性。
Objective:To explore the application value of abdominal ultrasound in diagnosis and posttreatment activity evaluation of children with inflammatory bowel disease(IBD).Method:A total of 82 suspected children with IBD were selected from Jiangxi Provincial Children's Hospital from January 2021 to January 2023.Colonoscopy and tissue biopsy results were used as the gold standard,a total of 77 cases were diagnosed with IBD(included in the IBD group),including 37 cases with Crohn's disease(included in the CD group)and 40 cases with ulcerative colitis(included in the UC group).Another 50 healthy children who underwent physical examination in our hospital were included in the health group.The sensitivity,specificity and accuracy of abdominal ultrasound diagnosis of IBD were calculated.Intestinal wall thickness,arterial resistance index(RI)and blood flow status were compared between IBD group and healthy group.The ultrasound image index,the coincidence rate of lesion location,the thickness of intestinal wall,arterial RI and blood flow status in active stage and remission stage were compared between the CD group and UC group.Result:The sensitivity,specificity and accuracy of abdominal ultrasound diagnosis of IBD were 92.21%,60.00%and 90.24%respectively.The intestinal wall thickness of IBD group was higher than that of healthy group,arterial RI level was lower than that of healthy group,and blood flow classification was worse than that of healthy group(P<0.05).The rates of disappearance of normal structure,interintestinal lymph node enlargement,interintestinal effusion and inflammatory mass in CD group were higher than those in UC group(P<0.05).The coincidence rate of lesion localization diagnosed by ultrasound was 94.59%of CD group and 90.00%of UC group.The thickness of intestinal wall in CD group was higher than that in UC group in active stage and remission stage,and the differences were statistically significant(P<0.05).In the active stage,the intestinal wall thickness was higher than that in the remission stage,and arterial RI level was lower than that in the remission stage(P<0.05).In the remission stage,the blood flow grading of intestinal wall between the two groups was better than that in the active stage(P<0.05).There were statistically significant differences in the blood flow classification of intestinal wall between the two groups(P<0.05).The AUC of intestinal wall thickness and arterial RI in diagnosis of CD activity was 0.790 and 0.741,and the AUC in diagnosis of UC activity was 0.668 and 0.714,respectively.Conclusion:Abdominal ultrasound has a high diagnostic value for IBD,which can accurately locate the lesion location,reduce misdiagnosis,and predict the activity of children after treatment.
作者
陈捷
吴蔚
郑巍
CHEN Jie;WU Wei;ZHENG Wei(Ultrasound Department,Jiangxi Provincial Children's Hospital,Nanchang 330006,China;不详)
出处
《中国医学创新》
CAS
2025年第1期134-139,共6页
Medical Innovation of China
基金
江西省卫生健康委科技计划项目(202410454)。
关键词
超声
炎症性肠病
诊断
Ultrasound
Inflammatory bowel disease
Diagnosis
