CEUS定量分析参数在克罗恩病评估中的应用研究  

Application of CEUS quantitative analysis parameters in evaluation of Crohn’s disease

作　　者：孟祥安 骆允 郝永欣 胡金雅 李阳 刘欢 MENG Xiang-an;LUO Yun;HAO Yong-xin;HU Jin-ya;LI Yang;LIU Huan(Department of Ultrasonography,Hebei Petro China Central Hospital,Langfang065000,Hebei,China)

机构地区：[1]河北中石油中心医院超声科,河北廊坊065000

出　　处：《生物医学工程与临床》2025年第1期65-70,共6页Biomedical Engineering and Clinical Medicine

基　　金：河北省廊坊市科学技术研究与发展计划(2022013121)。

摘　　要：目的探讨超声造影(CEUS)定量参数在评估肠道克罗恩病患者病情活动度中的应用价值。方法选择2022年1月至2023年6月在河北中石油中心医院经病理组织学检查确诊的100例克罗恩病患者,其中男性61例,女性39例;年龄28~60岁,平均年龄43.6岁;身体质量指数(BMI)20.54~24.82 kg/m^(2),平均BMI 22.96 kg/m^(2);吸烟28例,饮酒24例;粪便隐血阳性39例,阴性61例;高血压29例,糖尿病15例。根据患者所处疾病活动期情况将其分为缓解期和活动期。所有患者均行CEUS检查,对比两组患者的CEUS定量参数、肠道表现特征,并对各项差异具有统计学意义的指标绘制受试者工作特性(ROC)曲线,分析各项指标诊断肠道克罗恩病患者病情活动度的价值。结果根据患者所处疾病活动期情况将其分为缓解期组43例和活动期组57例。克罗恩病活动期组患者的CEUS检查肠壁厚度、峰值强度、上升斜率参数测定值均大于缓解期组患者[(8.05±2.54)mm vs(4.81±0.98)mm、(8.92±2.86)dB vs(4.98±0.81)dB、(0.74±0.28)dB/s vs(0.48±0.13)dB/s],活动期组患者CEUS检查的上升时间、达峰时间均低于缓解期组[(8.46±1.83)s vs(9.32±1.86)s、(7.64±1.48)s vs(9.54±1.82)s],差异有统计学意义(P<0.05);以差异有统计学意义的肠壁厚度、上升时间、峰值强度、上升斜率、达峰时间参数分别绘制ROC曲线,其诊断克罗恩病患者的ROC曲线下面积(AUC)值分别为0.771[95%可信区间(CI)0.669~0.874]、0.601(95%CI 0.490~0.712)、0.708(95%CI 0.583~0.833)、0.816(95%CI 0.723~0.910)、0.767(95%CI 0.678~0.859)。中重度活动期克罗恩病患者的CEUS检查肠壁厚度、峰值强度、上升斜率参数测定值均大于轻度活动期患者[(9.13±2.36)mm vs(7.21±2.24)mm、(9.96±2.27)dB vs(8.11±2.54)dB、(0.84±0.21)dB/s vs(0.66±0.26)dB/s],中重度活动期患者CEUS检查的上升时间、达峰时间均低于轻度活动期患者[(8.01±1.24)s vs(8.81±1.46)s、(7.20±1.32)s vs(7.98±1.41)s],差异有统Objective To explore application value of quantitative parameters of contrast-enhanced ultrasound(CEUS)in evaluating disease activity of patients with intestinal Crohn’s disease.Methods From January 2022 to June 2023,a total of 100 patents with Crohn’s disease confirmed by histopathological examination were enrolled,which included 61 males and 39 females,aged 28-60 years old with mean age of 43.6 years old;body mass index(BMI)was 20.54-24.82 kg/m^(2) with mean BMI of 22.96 kg/m^(2);28 cases of smoking and 24 of drinking;positive fecal occult blood of 39 cases and negative of 61;29 cases of hypertension and 15 of diabetes.According to disease activity,all patients were divided into remission stage and active stage.All of them underwent CEUS examination,the CEUS quantitative parameters and intestinal manifestations between 2 groups were compared.The receiver operating characteristic(ROC)curve was drawn for statistically significant indicators,and value of each index in the diagnosis of disease activity in patients with intestinal Crohn’disease was analyzed.Results According to disease activity,all patients were divided into remission stage group(n=43)and active stage group(n=57).In active stage group,the measured values of intestinal wall thickness,peak intensity and rising slope of CEUS were significantly higher than those in remission stage group[(8.05±2.54)mm vs(4.81±0.98)mm,(8.92±2.86)dB vs(4.98±0.81)dB,(0.74±0.28)dB/s vs(0.48±0.13)dB/s.P<0.05],rising time and peak time of CEUS examination were significantly lower than those in remission stage group[(8.46±1.83)seconds vs(9.32±1.86)seconds,(7.64±1.48)seconds vs(9.54±1.82)seconds.P<0.05],and the ROC curves were drawn with statistically significant differences parameters,including intestinal wall thickness,rising time,peak intensity,rising slope,and peak time.The area under curve(AUC)values for diagnosis of Crohn’s disease were 0.771[95%confidence interval(CI)0.669-0.874],0.601(95%CI 0.490-0.712),0.708(95%CI 0.583-0.833),0.816(95%CI 0.723-0.910),

关 键 词：超声造影 克罗恩病 活动度 受试者工作特性曲线 肠镜 

分 类 号：R445.1[医药卫生—影像医学与核医学] R574.62[医药卫生—诊断学]