经腹肠道超声诊断克罗恩病合并肠瘘及肠腔狭窄  

Transabdominal intestinal ultrasonography for diagnosing Crohn disease complicated with intestinal fistula and intestinal stenosis

作　　者：颜丽华 骆小冬 刘志 张妍琰[1] 覃辉 陈烁淳 李颖嘉[1] YAN Lihua;LUO Xiaodong;LIU Zhi;ZHANG Yanyan;QIN Hui;CHEN Shuochun;LI Yingjia(Department of Medical Ultrasound,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of General Practice,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院超声医学科,广东广州510515 [2]南方医科大学南方医院全科医学科,广东广州510515

出　　处：《中国医学影像技术》2022年第8期1192-1196,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察经腹肠道超声诊断克罗恩病(CD)合并肠瘘及肠腔狭窄的价值。方法回顾性分析337例CD患者,观察其肠道超声及CT小肠造影(CTE)表现,分析二者诊断CD合并肠瘘的一致性;以手术结果为金标准,评价超声及CTE诊断CD合并肠瘘和肠腔狭窄的效能。结果337例中,超声及CTE同时诊断CD合并肠瘘48例,诊断一致性极高(Kappa=0.848,P<0.01)。34例接受手术治疗,其中27例存在肠瘘;超声诊断CD合并肠瘘的敏感度、特异度及准确率分别为92.59%、71.43%及88.24%,CTE诊断的敏感度、特异度及准确率分别为96.30%、71.43%及91.18%,二者差异无统计学意义(McNemar P>0.05)。27例CD合并肠瘘患者中,18例同时合并肠腔狭窄;超声诊断CD合并肠瘘和肠腔狭窄的敏感度、特异度及准确率分别为88.89%、77.78%及85.19%,CTE诊断的敏感度、特异度及准确率均为88.89%,二者差异无统计学意义(McNemar P>0.05)。结论经腹肠道超声诊断CD合并肠瘘和肠腔狭窄效能较高,可媲美CTE。Objective To observe the value of transabdominal intestinal ultrasonography for diagnosing Crohn disease(CD)complicated with intestinal fistula and intestinal stenosis.Methods Data of 337 patients with CD were retrospectively analyzed.The manifestations of intestinal ultrasound and CT enterography(CTE)were observed,and the consistency between ultrasound and CTE for diagnosing CD complicated with intestinal fistula was analyzed,and the efficacy of ultrasonography and CTE was respectively evaluated taken surgical results as gold standards.Results Among 337 CD patients,48 were diagnosed with intestinal fistula through both ultrasound and CTE,and the diagnostic consistency between ultrasound and CTE was very high(Kappa=0.848,P<0.01).Totally 34 patients underwent surgery,among them intestinal fistula was confirmed in 27 cases.The sensitivity,specificity and accuracy of ultrasound for diagnosing CD complicated with intestinal fistula was 92.59%,71.43%and 88.24%,respectively,of CTE was 96.30%,71.43%and 91.18%,respectively.There was no significant difference of diagnostic efficacy between ultrasound and CTE(McNemar P>0.05).Among the above 27 CD patients complicated with intestinal fistula,intestinal stenosis was detected in 18 cases.The sensitivity,specificity and accuracy of ultrasound for diagnosing CD complicated with intestinal fistula and intestinal stenosis was 88.89%,77.78%and 85.19%,respectively,of CTE was all 88.89%.There was no significant difference of diagnostic efficacy between ultrasound and CTE(McNemar P>0.05).Conclusion Transabdominal intestinal ultrasound was effective for diagnosing CD complicated with intestinal fistula and intestinal stenosis,which was comparable to CTE.

关 键 词：克罗恩病 并发症 肠瘘 超声检查 

分 类 号：R574[医药卫生—消化系统] R445.1[医药卫生—内科学]