腹腔动脉、肠系膜上、下动脉彩色多普勒超声对克罗恩病活动期的诊断价值

Diagnostic Value of Color Doppler Ultrasound on Celiac Artery, Superior Mesenteric Artery and Inferior Mesenteric Artery in Active Crohn's Disease

背景:彩色多普勒超声作为一种非侵入性、无辐射的成像手段,在克罗恩病(CD)的临床诊断和监测中发挥越来越重要的作用。目的:探讨腹腔动脉(CA)、肠系膜上动脉(SMA)、肠系膜下动脉(IMA)彩色多普勒超声对CD活动期的诊断价值。方法:纳入2010年1月～2012年12月南京大学医学院附属鼓楼医院消化科收治的CD活动期患者29例,选取32例同时期因非肠道病变就诊的患者作为对照组。应用彩色多普勒超声对患者CA、SMA、IMA进行检测,记录管径、收缩期峰值流速(PSV)、舒张末期流速(EDV)以及阻力指数(RI)。结果:CD组CA的PSV值和RI值较对照组显著升高(P=0.0001),两组管径和EDV值差异无统计学意义(P=0.16;P=0.47)。CD组SMA的EDV值较对照组显著升高(P=0.03),两组管径、PSV、RI值差异无统计学意义(P=0.17;P=0.09;P=0.05)。CD组IMA的EDV值较对照组显著降低(P=0.04),两组管径、PSV、RI值差异无统计学意义(P=0.07;P=0.34;P=0.19)。结论:CD活动期CA、SMA和IMA的血流动力学参数发生显著改变,这对诊断CD和评估其活动性具有一定价值。

Background： Color Doppler ultrasound as a non-invasive and non-irradiating imaging approach is playing an important role in the diagnosis and monitoring of Crohn＇ s disease （CD） in clinical practice. Aims ： To investigate the diagnostic value of color Doppler ultrasound on celiac artery （CA）, superior mesenteric artery （SMA） and inferior mesenteric artery （IMA） in active CD. Methods： A total of 29 patients with active CD from Jan. 2010 to Dec. 2012 at The Affiliated Drum Tower Hospital of Nanjing University Medical School were enrolled, 32 patients with non-intestinal diseases were served as controls. The arterial cross-sectional diameter, peak systolic velocity （PSV）, end-diastolic velocity （EDV） and resistance index （RI） of CA, SMA and IMA were measured with color Doppler ultrasound. Results： The PSV and RI of CA in CD group were significantly higher than those in control group （ P = 0. 0001 ）. No significant differences in arterial cross- sectional diameter and EDV of CA were found between the two groups （P = 0. 16; P = 0.47）. The EDV of SMA in CD group was significantly higher than that in control group （P = 0.03 ）. No significant differences in arterial cross-sectional diameter, PSV and RI of SMA were found between the two groups （P = 0.17 ; P = 0.09 ; P = 0.05）. The EDV of IMA in CD group was significantly lower than that in control group （P = 0.04）. No significant differences in arterial cross-sectional diameter, PSV and RI of IMA were found between the two groups （P = 0.07 ; P = 0.34 ; P = 0.19）. Conclusions ： There are significant changes in hemodynamic parameters of CA, SMA and IMA in active CD patients. These changes might be used in the diagnosis of CD and assessment of CD activity.