影像检查评分评价Crohn病活动度的价值

Value of imaging findings score in valuing the activity of Crohn disease

目的 探讨MSCT小肠成像（MSCTE）、胶囊肠镜（CE）和增强超声（CEUS）检查评分评价Crohn病（CD）活动度的价值.方法 前瞻性收集经内镜检查结合临床或病理结果确诊为CD,且Crohn病活动指数（CDAI）≥150分的108例患者纳入研究.108例均行MSCTE检查,其中48例同时行CEUS检查,60例同时行CE检查,并分别进行影像评分.同时测量患者的C反应蛋白（CRP）,并结合临床表现进行CDAI评分.采用Pearson法分析各影像评分与CDAI、CRP之间的相关性.结果 MSCTE、CEUS和CE评分分别为（7.6±2.7）、（11.5±4.3）和（12.8±8.2）分,CDAI评分为（296.1±93.5）分,CRP为（23.7±5.2） mg/L.MSCTE评分与CDAI评分成高度相关（r=0.916,P＜0.01）; CEUS、CE评分与CDAI评分间均成中度相关（r分别为0.752和0.707,P均＜0.01）;MSCTE、CEUS评分与CRP间无相关性（r值分别为0.167和0.200,P均＞0.05）;CE评分与CRP间成低度相关性（r=0.467,P＜0.01）.结论 MSCTE评分与CD患者活动度有较好的相关性,可用于评估患者的活动度.

Objective To evaluate the value of multi-slice CT enterography（MSCTE）,capsule endoscopy（CE） and contrast-enhanced ultrasound（CEUS） findings score in the assessment of Crohn disease activity,prospectively.Methods One hundred and eight patients were diagnosed with CD by endoscopy combined with clinical or pathological results,and all of the patients＇ Crohn disease activity index（CDAI） were greater than or equal to 150.MSCTE were performed in all the patients.At the same time,48 and 60 patients of them were voluntary to accept CEUS and CE examination,respectively.The imaging score of the three different techniques was calculated.Patients＇ CDAI were calculated combined with the C-reactive protein（CRP） content and clinical feature.To analyze the correlation among the imaging score patients＇ CDAI,and CRP content,respectively using the Pearson method.Results The mean score of MSCTE,CEUS and CE were（7.6±2.7）,（11.5 ±4.3） and（12.8±8.2）,respectively.The patients＇ mean CDAI and CRP content were（296.1±93.5） and（23.7±5.2） mg/L,respectively.It was high correlation between MSCTE score and CDAI （r=0.916,P＜0.01）,but it was moderate between CEUS（r=0.752,P＜0.01）,CE（r=0.707,P＜0.01） score and CDAI.There was no evident correlation between MSCTE（r=0.167,P＞0.05）,CEUS（r=0.200,P＞0.05） score and CRP content excepting the CE result（r=0.467,P＜0.01）.Conclusions There was a good correlation between the MSCTE score and CDAI.We could use MSCTE findings score to assess the activity of CD patients prospectively.