克罗恩病透壁愈合的超声评估方法和价值  

Ultrasound evaluation of transmural healing in Crohn′s disease:methods and values

作　　者：程文捷[1,2] 覃斯 梁焯华 刘广健 Cheng Wenjie;Qin Si;Liang Zhuohua;Liu Guangjian(Department of Ultrasound,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院超声科,广州510655 [2]广东省结直肠盆底疾病研究重点实验室,广州510655

出　　处：《中华炎性肠病杂志（中英文）》2023年第1期27-31,共5页Chinese Journal of Inflammatory Bowel Diseases

摘　　要：随着疾病诊疗手段的进步,克罗恩病的治疗目标也经历了由临床缓解到黏膜愈合,最终到追求透壁愈合的演变,且越来越多的研究发现透壁愈合与患者更好的长期预后具有显著相关性。但目前对透壁愈合的定义和评估标准尚不统一,通过超声技术评估透壁愈合的研究普遍采用肠壁厚度≤3 mm,伴或不伴肠壁血流信号正常作为标准。尽管常规超声的其他参数(肠壁层次、肠系膜炎性脂肪)以及超声造影和超声弹性成像等新技术在一定程度上与炎症活动相关,但尚无足够证据证明其在评价透壁愈合的价值。我们建议临床上采用正常的肠壁厚度及肠壁血流作为超声评价透壁愈合的标准。With the progress of disease diagnosis and treatment,the treatment goals of Crohn′s disease have evolved from clinical remission to mucosal healing,and ultimately towards transmural healing.Accumulating evidence suggests a good association between transmural healing and a better long-term outcome.However,the definition and evaluation criteria of transmural healing reported in literatures are not uniform at present.The bowel wall thickness≤3 mm with or without normal color doppler signal assessed by doppler ultrasound is regarded as the criterion of transmural healing in most of studies.Although other parameters of conventional ultrasound(bowel wall stratification and inflammatory mesenteric fat)and new ultrasound techniques(contrast enhanced ultrasound and ultrasound elastic imaging)are related to inflammatory activity to a certain extent,there is no sufficient evidence to prove their value in evaluating transmural healing.We suggest that normal bowel wall thickness and bowel wall flow should be used as the criteria for evaluating transmural healing.

关 键 词：克罗恩病 透壁愈合 肠道超声 肠壁厚度 彩色多普勒信号 

分 类 号：R574.62[医药卫生—消化系统] R445.1[医药卫生—内科学]