经腹低频联合高频超声对克罗恩病的临床诊断价值  

Clinical Diagnostic Value of Transabdominal Low-Frequency Combined With High-Frequency Ultrasound for Crohn's Disease

作　　者：黄丽健 包燕妮 谢春眉 HUANG Lijian;BAO Yanni;XIE Chunmei(Department of Ultrasound Imaging,the Second Affiliated Hospital of Xiamen Medical College,Xiamen Fujian 361023,China)

机构地区：[1]厦门医学院附属第二医院超声影像科,福建厦门361023

出　　处：《中国卫生标准管理》2023年第20期78-81,共4页China Health Standard Management

摘　　要：目的探讨经腹超声诊断肠道克罗恩病(Crohn's disease,CD)的临床价值。方法选取2019年1月—2022年5月厦门医学院附属第二医院收治的41例行经腹彩色多普勒超声检查的CD患者,分析异常肠段超声图像,并与内镜和核磁共振检查结果对照;对受累肠壁血流进行分级,并检测粪便钙卫蛋白(+、-)性。结果CD超声的特征表现为受累肠壁不同程度增厚,呈“三明治征”“同心圆征”“水管征”;内膜面呈“平板状”或“鹅卵石样”改变,肠壁周围可出现肿大淋巴结及“脂肪爬行征”;较大的溃疡黏膜面超声能显示,而且可以实时观察到异常的肠管蠕动。其常见并发症有肠管狭窄、炎性包块、窦道形成、肠道穿孔及脓肿等;根据发病部位分型小肠-结肠型最多见(56.10%,23/41)、小肠型(26.83%,11/41)、结肠型(17.07%,7/41),活动期受累肠壁血流分级与粪便钙卫蛋白(+)性存在显著相关(r=0.57,P<0.01),一致性中等(Kappa=0.56,P<0.01)。结论经腹低频结合高频超声检查对临床在CD的诊断和随访中存在一定的优势。Objective To investigate the clinical value of transabdominal ultrasound in the diagnosis of intestinal Crohn's disease(CD).Methods A total of 41 patients with CD admitted to the Second Affiliated Hospital of Xiamen Medical College from January 2019 to May 2022 were selected for transabdominal color doppler ultrasound examination.Abnormal intestinal segment ultrasound images were analyzed and compared with endoscopic and magnetic resonance imaging results.Grading the affected intestinal wall blood flow and detecting fecal calprotectin(+,-)levels.Results The ultrasonic characteristics of CD showed that the affected intestinal wall was thickened in different degrees,showing"sandwich sign""concentric circle sign"and"water pipe sign".The intimal surface is"flat"or"cobblestone",and there may be enlarged lymph nodes and"fat crawling sign"around the intestinal wall.The larger mucosal surface of ulcers can be shown on ultrasound and abnormal bowel peristalsis can be observed frequently.The common complications were intestinal stenosis,inflammatory mass,sinus formation,intestinal perforation and abscess.According to the location of the disease,the most common types were entero-colonotype(56.10%,23/41),intestinal type(26.83%,11/41)and colonotype(17.07%,7/41).There was a significant correlation between the blood flow grading of the affected intestinal wall and fecal calprotectin(+)(r=0.57,P<0.01).There was moderate agreement(Kappa=0.56,P<0.01).Conclusion Transabdominal low-frequency combined with high-frequency ultrasound has certain advantages in the diagnosis and follow-up of CD.

关 键 词：低频超声 高频超声 肠壁增厚 联合诊断 克罗恩病 钙卫蛋白 

分 类 号：R737[医药卫生—肿瘤]