克罗恩病活动期常规超声及超声造影特征分析  

Imaging features of active Crohn′s disease on conventional ultrasound and contrast-enhanced ultrasound

作　　者：刘畅[1,2] 徐晓蓉[1,2] 徐辉雄[1,2] 张一峰[1,2] 郑曙光[1,2] 郭乐杭[1,2] 孙丽萍[1,2] 刘琳娜[1,2] 吴剑[1,2] 

机构地区：[1]同济大学附属第十人民医院 [2]上海市第十人民医院超声医学科,200072

出　　处：《中华医学超声杂志（电子版）》2013年第11期49-53,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：教育部新世纪优秀人才支持计划项目(NCET-06-0723);上海市卫生局重点项目(20114003);上海市人才发展基金(2012045)

摘　　要：目的分析克罗恩病活动期常规超声及超声造影特征。方法回顾性分析2011年8月至2012年12月上海市第十人民医院经临床确诊为克罗恩病活动期的20例患者，观察其腹部常规超声及超声造影特征。测量病变段肠壁全层、内侧及外侧肠壁厚度、内外侧肠壁厚度之比；对肠壁能量多普勒超声表现进行Limberg分型；测量肠壁造影剂到达时间、达峰时间、流入时间。不同Limberg分型克罗恩病患者肠壁厚度、造影剂到达时间、达峰时间、流入时间比较应用方差分析，进一步组间两两比较应用LSD．t检验。结果20例克罗恩病患者肠壁全层厚度均大于4mm，为5．5～12．0mm，平均（8．8±0．4）mm；内外侧肠壁厚度之比均大于1。20例克罗恩病患者LimbergII型2例、III型8例、Ⅳ型10例。超声造影主要表现为2种增强模式：13例（13／20，65．0％）表现为内外侧肠壁同时开始的全肠壁增强；7例（7／20，35．0％）表现为从内侧肠壁开始的以内侧肠壁为主的增强。LimbergII型、III型、Ⅳ型克罗恩病患者肠壁全层厚度分别为（6．6±0．1）、（7．5±0．4）、（10．2±0．4）mm，内侧肠壁厚度分别为（3．6±0．6）、（5．0±0．2）、（7．3±0.3）mm，超声造影达峰时间分别为（30．5±2．1）、（26．9±2．4）、（21，0±1．6）S，流入时间分别为（18．0±5．7）、（10．6±1．0）、（8．7±1．2）S。随着Limberg分型增加，克罗恩病患者肠壁全层厚度、内侧肠壁厚度均增加，超声造影达峰时间及流入时间亦增加，且差异均有统计学意义。随着Limberg分型增加，克罗恩病患者内外侧肠壁厚度比也增加，但差异均无统计学意义。不同Limberg分型克罗恩病患者外侧肠壁厚度、肠壁造影剂到达时间差异均无统计学意义。结论克罗恩活动期患者常规超声主要表现为肠壁增厚，能量多普勒Limberg分型增加：超声造影主要Objective To investigate the imaging features of active Crohn＇s disease on conventional ultrasound and contrast-enhanced ultrasound （CEUS）. Methods The imaging features of 20 patients with an established diagnosis of Crohn＇s disease on transabdominal high-frequency ultrasound and contrast- enhanced ultrasound in Shanghai Tenth People＇s Hospital from August 2011 to December 2012 were studied retrospectively. Contrast-specific imaging modes were performed and the ultrasound contrast agent was SonoVue. The thickness of inner, outer and all layers of intestinal walls in the lesion area were observed; the ratio between inner and outer bowel wall thickness was calculated; Limberg classification was determined by Power-Doppler results. Likewise, contrast-enhanced ultrasound was used to evaluate the degree and area of bowel wall enhancement, as well as the changes over time. Variance analysis was applied to compare intestinal wall thickness, arrive time of contrast agent, time to peak and washing time of patients with Crohn＇s disease from different Limberg groups, and further comparison between groups were anlysed with LSD-t test. Results The intestinal wall thickness of all 20 patients was larger than 4 ram, while the mean thickness of intestinal wails was （8.8 ±0.4） mm （range 5.5-12.0 mm）; the ratio between inner and outer wall thickness was greater than 1.0. Limberg classification was II in 2 patients, III in 8 patients and 1V in 10 patients. There were two enhancement patterns shown on contrast-enhanced ultrasound： Pattern 1 in 13 （13/20, 65.0%） patients showing simultaneous enhancement in both inner and outer intestinal walls at the same time. Pattern 2 in 7 （7/20, 35.0%） patients showing outward enhancement from inner to outer wall with a predominance of inner wall. The wall thicknesses of patients with Crohn＇s disease from Limberg II group, Limberg III group and Limberg IV group were （6.6±0.1）, （7.5±0.4） and （10.2±0.4） mm respectively. The thicknesses of inner bowel

关 键 词：克罗恩病 超声检查 造影剂 

分 类 号：R445.1[医药卫生—影像医学与核医学]