经腹联合经会阴超声在克罗恩病管理中的临床价值
Clinical value of transabdominal combined with transperineal ultrasound in the management of Crohn's disease
席芬 1柳建华1
作者信息
- 1. 510180 广州市第一人民医院超声医学科
- 折叠
摘要
目的 探讨经腹联合经会阴超声检查在克罗恩病管理中的临床应用价值.方法 选取我院收治的克罗恩病患者87例,均应用经腹联合经会阴超声检测末段回肠及结直肠的肠壁厚度、肠壁血流分布及肠外并发症情况,剪切波弹性成像检测肠壁杨氏模量平均值;肠镜检查肠壁炎症程度,并进行简化克罗恩病内镜评分(SES-CD)分期及组织学活检;实验室检查获得血清超敏C反应蛋白.分析各超声参数与肠镜检查结果、血清超敏C反应蛋白的相关性.结果 87例克罗恩病患者中,同时进行超声及肠镜检查的肠段共435个,肠镜检查提示缓解期肠段326个(74.9%),活动期肠段109个(25.1%).其中末段回肠受累者59.8%(52/87)处于活动期.超声提示187个肠段有不同程度肠壁增厚,以末段回肠肠壁增厚最多见(40.2%),且64.4%末段回肠肠壁血流增多,多为LimbergⅡ级(47.1%);肠外并发症以淋巴结可见或增大为主(48.3%).共96个肠段进行剪切波弹性成像检查,肠壁杨氏模量平均值为0.8～77.1 kPa.相关性分析显示,肠壁厚度、Limberg血流分级均与SES-CD分期呈高度正相关(r=0.796、0.742,均P<0.001);末段回肠肠壁厚度、Limberg血流分级分别与血清超敏C反应蛋白呈中度正相关、弱正相关(r=0.496、0.399,均P<0.05);各肠段肠壁杨氏模量平均值与SES-CD评分无相关性.结论 经腹联合经会阴超声能够清晰显示克罗恩病患者的肠道病变及肠外并发症,可以较准确地评估疾病活动度,有一定的临床应用价值.
Abstract
Objective To explore the clinical application value of transabdominal combined with transperineal ultrasound in the management of Crohn's disease.Methods A total of 87 patients with Crohn's disease admitted to our hospital were selected.The thickness of intestinal wall,intestinal wall blood flow grading and parenteral complications of terminal ileum and colon were detected by transabdominal combined with transperineal ultrasonography.The intestinal wall elasticity was measured by shear wave elastography(SWE).Colonoscopy was performed to assess the degree of bowel wall inflammation,the simple endoscopic score for Crohn's disease(SES-CD)staging and histological biopsy were performed.The serum high-sensitivity C-reactive protein(hs-CRP)was measured by laboratory tests.The correlation between ultrasound parameters and colonoscopy results,as well as serum hs-CRP was analyzed.Results A total of 435 intestinal segments were examined by ultrasound and colonoscopy among the 87 patients with Crohn's disease.The results of colonoscopy showed that 326(74.9%)intestinal segments were in the remission stage,while 109(25.1%)were in the active stage.Among these active segments,59.8%(52/87)were located in the terminal ileum.The results of ultrasound showed that 187 intestinal segments had different degrees of intestinal wall thickening,of which the terminal ileum had the most thickening(40.2%),and 64.4%had increased intestinal wall blood flow,most of which were Limberg Ⅱ grade(47.1%).Lymph nodes were visible or enlarged(48.3%).A total of 96 intestinal segments were examined by SWE,with intestinal wall elasticity ranging from 0.8 kPa to 77.1 kPa.Correlation analysis showed that there were a strong positive correlation between intestinal wall thickness,Limberg blood flow grade and SES-CD stage(r=0.796,0.742,both P<0.001).The thickness of the terminal ileum wall and Limberg blood flow grade were moderately positively correlated with serum hs-CRP(r=0.496,0.399,both P<0.05).However,no correlation was observed between each intestinal wall elasticity and SES-CD score.Conclusion Transabdominal combined transperineal intestinal ultrasound provides clear visualization of intestinal lesions and parenteral complications in patients with Crohn's disease.It offers an accurate evaluation of the level of lesion activity,which has certain clinical application value.
关键词
超声检查,经腹部,经会阴/克罗恩病/肠壁弹性/超敏C反应蛋白Key words
Ultrasonography,transabdominal,transperineal/Crohn's disease/Intestinal wall elasticity/High-sensitivity C-reactive protein引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据