溃疡性结肠炎及克罗恩病应用超声造影定量分析的疾病评估研究  

Evaluationof Ulcerative Colitis and Crohn's Disease by Contrast-Enhanced Ultrasound Quantitative Analysis

作　　者：李珍艳 杨小莉[1] 李罗红[1] 欧艳[1] 李小琼[1] 张俊丽[1] Li Zhenyan;Yang Xiaoli;Li Luohong(West China Hospital of Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西医院,四川成都610041

出　　处：《四川医学》2024年第4期357-362,共6页Sichuan Medical Journal

摘　　要：目的探究溃疡性结肠炎及克罗恩病应用超声造影定量分析的疾病评估情况。方法选取2020年4月至2022年4月我院收治的123例炎症性肠病患者为研究对象,对所有患者行常规超声、超声造影及肠内镜检查,并对其进行定量分析,以患者病理学检查结果为金标准,研究患者经超声检查的诊断准确率情况,并分析克罗恩病和溃疡性结肠炎患者的超声指标;根据患者是否处于疾病活动期(参照克罗恩病活动指数评分表及改良Mayo量表)对克罗恩病和溃疡性结肠炎患者进行分组,分析活动组和非活动组患者肠壁厚度、血流能量多普勒血流分级情况、超声造影强化模式及定量参数情况。结果123例患者中,病理诊断64例为溃疡性结肠炎,59例为克罗恩病,超声对克罗恩病诊断准确率为81.36%,对溃疡性结肠炎的诊断准确率为82.81%,超声诊断患者炎性肠病的总准确率为82.11%。克罗恩病患者正常结构消失、淋巴结肿大、肠间积液、粘连包块发生占比高于溃疡性结肠炎患者,差异有统计学意义(P<0.05)。与克罗恩病患者的非活动组比较,活动组患者的肠壁厚度升高,血流2~3级及全层增强占比升高(P<0.05);克罗恩病活动组和非活动组患者的超声AT、AS比较差异无统计学意义(P>0.05),活动组患者的PI水平高于非活动组,TTP低于非活动组(P<0.05)。与溃疡性结肠炎患者的非活动组比较,活动组患者的肠壁厚度升高,血流2~3级及全层增强占比升高(P<0.05);溃疡性结肠炎活动组和非活动组患者的超声TTP、AS比较差异无统计学意义(P>0.05),活动组患者的PI水平高于非活动组,AT水平低于非活动组(P<0.05)。结论超声造影定量分析在溃疡性结肠炎和克罗恩病的诊断中具有一定的准确性。超声可以帮助观察炎性肠病的肠壁厚度、血流情况等表现,并在疾病活动期的评估中发挥一定的作用。Objective To investigate quantitative evaluation of ulcerative colitis and Crohn's disease by contrast-enhanced ultrasound.Methods Total 123 patients with inflammatory bowel disease admitted to our hospital from April 2020 to April 2022 were selected as subjects of this study.Routine ultrasound,contrast-enhanced ultrasound and intestinal endoscopy were performed on all patients,and quantitative analysis was performed.With pathological examination standard as the gold standard,diagnostic accuracy of ultrasonic examination was studied,and ultrasonic indexes of patients with Crohn's disease and ulcerative colitis were analyzed.Patients with Crohn's disease and ulcerative colitis were divided according to whether patients were in active stage of disease(referring to Crohn's disease activity index rating scale and modified Mayo scale),and intestinal wallthickness,blood flow energy Doppler blood flow grading,enhanced contrast ultrasound mode and quantitative parameters of the patients in active and inactive groups were analyzed.Results Among 123 patients,64 cases were pathologically diagnosed as ulcerative colitis and 59 cases as Crohn's disease.The accuracy rate of ultrasound diagnosis for Crohn's disease and ulcerative colitis was 81.36%,82.81%.And total accuracy rate of ultrasound diagnosis for inflammatory bowel disease was 82.11%.The proportion of normal structure disappearance,lymph node enlargement,intestinal fluid accumulation,and adhesive masses in patients with Crohn's disease is higher than that in patients with ulcerative colitis,and the difference is statistically significant(P<0.05).Compared with the non active group of Crohn's disease patients,the active group had an increase in intestinal wall thickness,and a higher proportion of blood flow grade 2~3 and full layer enhancement(P<0.05).There was no statistically significant difference in ultrasound AT and ASbetween the active and non active groups of patients with Crohn's disease(P>0.05).The PI level of the active group was higherthan that of the non act

关 键 词：溃疡性结肠炎 克罗恩病 炎症性肠病 超声造影 定量分析 疾病评估 

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