摘要
目的 探讨肠道超声(IUS)评估溃疡性结肠炎(UC)内镜活动的准确性.方法 采用横断面调查研究方法,连续纳入2022年6月至2023年9月就诊于郑州大学第一附属医院的UC患者.所有患者行IUS和结肠镜检查,根据Mayo内镜评分(MES)将肠段分为缓解组和活动组,分析缓解组与活动组各超声参数的差异,探讨各超声参数评估UC内镜活动的准确性.结果 纳入80例UC患者共315个结肠段,缓解组171段,活动组144段.与活动组相比,缓解组肠段的肠壁厚度(BWT)[2.40(1.90,3.50)mm 比4.70(3.50,6.00)mm,P＜0.001]、肠壁血流(CDS)≥2级(5.8％比49.3％,P＜0.001)、肠系膜脂肪增厚(14.0％比50.7％,P＜0.001)、淋巴结肿大(4.1％比23.6％,P＜0.001)、肠壁分层异常(14.6％比60.4％,P＜0.001)均更低,差异均具有统计学意义.ROC曲线显示,BWT、CDS、肠系膜脂肪、肠系膜淋巴结、肠壁分层评估内镜活动的敏感度分别为77.8％、49.3％、50.7％、23.6％、60.4％,特异度分别为74.3％、94.2％、86.0％、95.9％、85.4％.结论 IUS评估UC内镜活动具有良好的准确性,BWT、CDS、肠系膜脂肪、肠系膜淋巴结是评估UC内镜活动重要的超声参数.
Abstract
Objective To investigate the accuracy of intestinal ultrasound(IUS)in evaluating endoscopic activity of ulcerative colitis(UC).Methods A cross-sectional survey study was conducted.Consecutive patients with UC at the First Affiliated Hospital of Zhengzhou University were recruited from June 2022 to September 2023.All the patients underwent IUS and colonoscopy.The colorectal segments were divided into remission and activity groups based on the Mayo endoscopic score(MES).The differences in IUS parameters between the remission and activity groups were compared.The accuracy of IUS parameters in diagnosing UC endoscopic activity was discussed.Results A total of 315 colorectal segments from 80 patients were enrolled,including 171 colorectal segments in the remission group,and 144 were in the activity group.Compared with the colorectal segments in the activity group,bowel wall thicknessc(BWT)[2.40(1.90,3.50)mm vs.4.70(3.50,6.00)mm,P＜0.001],colour doppler signal(CDS)≥2(5.8％vs.49.3％,P＜0.001),fatty wrapping(14.0％vs.50.7％,P＜0.001),presence of lymph nodes(4.1％vs.23.6％,P＜0.001),abnormal wall layer stratification(14.6％vs.60.4％,P＜0.001)were significantly lower in the remission group.ROC curve showed that the sensitivity of BWT,CDS,fatty wrapping,presence of lymph nodes,and abnormal wall layer stratification assessment of endoscopic activity was 77.8％,49.3％,50.7％,23.6％,and 60.4％,while the specificity was 74.3％,94.2％,86.0％,95.9％and 85.4％respectively.Conclusion IUS demonstrates favorable accuracy in assessing the endoscopic activity of UC,BWT,CDS,wall layer stratification,fatty wrapping,presence of lymph nodes are crucial parameters for evaluating endoscopic activity in UC.
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