经腹肠道超声和磁共振小肠造影对小肠受累克罗恩病诊断价值的对比研究  

Comparative study on the diagnostic value of transabdominal intestinal ultrasound and MR enterography for small bowel Crohn's disease

作　　者：李文波[1] 王昭珏 刘炜 刘婧娟 孝梦甦 马莉 张晓燕 秦菁 周梦园 牛梓涵 朱庆莉[1] Li Wenbo;Wang Zhaojue;Liu Wei;Liu Jingjuan;Miao Mengsu;Ma Li;Zhang Xiaoyan;Qin Jing;Zhou Mengyuan;Niu Zihan;Zhu Qingli(Department of Ultrasound,Peking Union Medical College Hospital,Beijing 100730,China;不详)

机构地区：[1]中国医学科学院、北京协和医学院、北京协和医院超声医学科,北京100730 [2]中国医学科学院、北京协和医学院、北京协和医院放射科,北京100730

出　　处：《临床内科杂志》2024年第7期451-455,共5页Journal of Clinical Internal Medicine

基　　金：中央高水平医院临床科研业务费资助项目(2022-PUMCH-B-066)。

摘　　要：目的 探讨经腹肠道超声(IUS)与磁共振小肠造影(MRE)对于小肠受累克罗恩病(CD)患者诊断价值的对比研究。方法 回顾性纳入2018~2023年我院住院治疗存在小肠受累且同期进行过IUS及MRE的CD患者41例分析所有患者临床资料及IUS、MRE特征,比较两种影像学方法对于CD小肠病变检出情况及位置、范围、并发症的诊断价值。结果 41例患者中,男31例、女10例,年龄10~59岁,平均年龄(28.4±11.8)岁,活动期17例、缓解期24例,17例曾行CD相关手术(包括肠道手术9例及肛周手术8例)。IUS和MRE对所有CD患者及24例缓解期患者阳性病变诊断的一致性均较好(0.6<κ≤0.8);对小肠、结肠、末段回肠、空肠、回肠病变、肠瘘、有肠道手术史的CD患者阳性病变诊断的一致性均较好(0.6<κ≤0.8);对肠壁增厚诊断的一致性中等(0.4<κ≤0.6);对无肠道手术史的CD患者阳性病变的诊断完全一致。结论 IUS对小肠受累CD患者病变性质及部位诊断的准确性好,对CD患者诊断及随访有重要价值。Objective To evaluate the comparative study of the diagnostic value of transabdominal intestinal ultrasound(IUS)and MR enterorrhaphy(MRE)for patients with Crohn's disease(CD)with small bowel involvement.Methods A retrospective study was conducted on 41 hospitalized CD patients with small bowel involvement between 2018 and 2023 who underwent both IUS and MRE at the same period.Clinical data and imaging features from IUS and MRE of all patients were analyzed.The diagnostic value of IUS and MRE for detecting positive findings,lesion locations,extents,and complications was compared.Results Among the 41 patients,there were 31 males and 10 females,aged 10~59 years with an average age of(28.4±11.8)years.17 cases were in active stage and 24 were in remission stage.17 cases had undergone CD-related surgeries(comprising 9 intestinal surgeries and 8 perianal surgeries).The diagnostic consistency of positive lesions by IUS and MRE was good in all CD patients and 24 cases in remission stage(0.6<k≤0.8);the diagnostic consistency of positive lesions in small bowel,colon,terminal ileum,jejunum,ileocecal lesions,intestinal fistulas and CD patients with a history of intestinal surgery was good(0.6<k≤0.8);the diagnostic consistency of intestinal wall thickening was moderate(0.4<k≤0.6);the diagnosis of positive lesions in CD patients without a history of intestinal surgery was completely consistent.Conclusion IUS demonstrates good consistency in the diagnosis of the nature and lesions in CD patients with small bowel involvement,and was valuable in the diagnosis and follow-up of CD patients.

关 键 词：克罗恩病 小肠 肠道超声 磁共振小肠造影 

分 类 号：R574.5[医药卫生—消化系统]