Assessment of perianal fistulizing Crohn’s disease activity with endoanal ultrasound: A retrospective cohort study  

作　　者：Na Hong Wei-Yong Liu Jin-Long Zhang Kai Qian Jie Liu Xian-Jun Ye Fei-Yan Zeng Yue Yu Kai-Guang Zhang 

机构地区：[1]Cheeloo College of Medicine,Shandong University,Jinan 250012,Shandong,China [2]Department of Gastroenterology,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,Anhui Province,China [3]Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,Anhui Province,China [4]Department of Ultrasound Medicine,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,Anhui Province,China [5]Department of Rehabilitation Medicine,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China [6]Department of Radiology,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,Anhui Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第8期2494-2502,共9页世界胃肠外科杂志（英文版）（电子版）

基　　金：the Major Project of Department of Education of Anhui Province of China,No.2023AH040396.

摘　　要：BACKGROUND Perianal fistulas pose dual challenges to Crohn's disease(CD)patients.Low patient compliance due to the complexity of existing examination methods plagues the treatment and follow-up management of perianal CD.AIM To determine the accuracy of endoanal ultrasound(EUS)and shear wave elastography(SWE)for evaluating perianal fistulizing CD(PFCD)activity.METHODS This was a retrospective cohort study.A total of 67 patients from August 2022 to December 2023 diagnosed with CD were divided into three groups:Non-anal fistula group(n=23),low-activity perianal fistulas[n=19,perianal disease activity index(PDAI)≤4],high-activity perianal fistulas(n=25,PDAI>4)based on the PDAI.All patients underwent assessments including EUS+SWE,pelvic magnetic resonance[pelvic magnetic resonance imaging(MRI)],C-reactive protein,fecal calprotectin,CD activity index,PDAI.RESULTS The percentage of fistulas indicated by pelvic MRI and EUS was consistent at 82%,and there was good consistency in the classification of perianal fistulas(Kappa=0.752,P<0.001).Significant differences were observed in the blood flow Limberg score(χ^(2)=8.903,P<0.05)and shear wave velocity(t=2.467,P<0.05)between group 2 and 3.Shear wave velocity showed a strong negative correlation with magnetic resonance novel index for fistula imaging in CD(Magnifi-CD)score(r=-0.676,P<0.001),a weak negative correlation with the PDAI score(r=-0.386,P<0.05),and a weak correlation between the Limberg score and the PDAI score(r=0.368,P<0.05).CONCLUSION EUS combined with SWE offers a superior method for detecting and quantitating the activity of perianal fistulas in CD patients.It may be the ideal tool to assess PFCD activity objectively for management strategies.

关 键 词：Endoanal ultrasound Shear wave elastography Perianal fistulizing Crohn’s disease Perianal disease activity index 

分 类 号：R656.7[医药卫生—外科学]