CEUS评估克罗恩病活动度的可行性

Feasibility of CEUS in assessment of Crohn disease activity

目的探讨CEUS评估克罗恩病活动度的可行性。方法回顾性分析经临床确诊为克罗恩病的39例患者,其中临床疾病活动指数(CDAI)评分<150分(缓解期)18例,150~450分(活动期)21例,分别测量肠壁厚度,对增厚肠壁根据能量多普勒超声表现进行Limberg分型,并分别进行CEUS,对比分析上升时间、峰值强度、平均渡越时间、峰值降半时间、上升斜率及达峰时间的差异。结果活动期患者的肠壁厚度、峰值强度及上升斜率明显高于缓解期,差异均有统计学意义(P均<0.05)。活动期LimbergⅠ型1例,LimbergⅡ型4例,LimbergⅢ型10例,LimbergⅣ型6例;缓解期LimbergⅠ型10例,LimbergⅡ型7例,LimbergⅢ型1例。活动期肠壁血流以LimbergⅢ、Ⅳ型为主,缓解期以Ⅰ、Ⅱ型为主,差异有统计学意义(P<0.001)。结论 CEUS可为克罗恩病活动度的评估提供定量资料,具有一定的临床应用价值。

Objective To evaluate the feasibility of CEUS in Crohn disease（CD）activity.Methods Thirty-nine patients with CD were analyzed.The clinical disease activity index of 18 cases were less than 150（inactivity）,and 21 cases were between 150 and 450（activity）.The thickness of intestinal walls were measured and Limberg classification were determined by power-Doppler results.The CEUS was performed,and the parameters including rise time,peak intensity,mean transit time,time from peak to one half,wash in slope and time to peak were statistical analyzed.Results The thickness of the lesions,peak intensity and wash in slope of activity CD were greater than those of inactivity CD,which had significant difference（all P〈0.05）.The Limberg classification of typeⅠ was 1 case,type Ⅱ was 4 cases,type Ⅲ was 10 cases and type Ⅳ was 6 cases in activity CD.The Limberg classification of typeⅠ was 10 cases,typeⅡ was 7 cases and type Ⅲ was 1 case.The Limberg classification were mainly typeⅢand typeⅣin activity CD,and typeⅠand typeⅡin inactivity CD,which had significant difference（P〈0.001）.Conclusion CEUS can provide quantitative parameters in CD activity and has great clinical value.