能量多普勒超声评估炎症性肠病活动度的实用价值探讨

Practical value of energy Doppler ultrasonography in evaluating the activity of inflammatory bowel disease

目的探讨能量多普勒超声评估炎症性肠病活动度的实用价值。方法选择2016年1月～2017年1月在我院住院治疗的IBD患者30例作为观察对象,另选择同期健康体检者30例作为对照组,采用灰阶超声结合能量多普勒超声技术着重对病变段肠壁厚度、血供进行观察,并与健康人群对照。对上述IBD患者进行定期随访,对同一患者不同时期肠壁厚度、血供情况等进行对比分析,用Limberg分级法评价其活动度。随访IBD患者的肠镜检查结果,并与超声结果对比。结果 IBD患者活动期和缓解期肠壁厚度显著大于对照组,动脉阻力指数显著低于对照组,活动期和缓解期的肠壁厚度、动脉阻力指数比较,差异不显著(P>0.05)。内镜判断IBD活动期12例、缓解期18例,并与超声结果对比。以内镜结果参照,应用灰阶超声对IBD患者活动性判断的符合率为100%。结论灰阶超声结合能量多普勒超声对炎症性肠病活动性的评估,作为内镜检查的有效补充,不仅可以观察病变段肠壁厚度、肠壁血供等,对IBD患者病情监测及治疗方案的调整具有重要的临床指导意义。

Objective To explore the practical value of energy Doppler ultrasonography in evaluating the activity of inflammatory bowel disease.Methods 30 patients with IBD who were hospitalized in our hospital from January 2016 to January 2017 were selected as observation subjects.Another 30 healthy subjects were selected as the control group.The gray-scale ultrasound combined with energy Doppler ultrasound was used to mainly observe the thickness and blood supply of the intestinal wall of the lesion.And the data were compared with those of the healthy people.The above-mentioned IBD patients were followed up regularly,and the intestinal wall thickness and blood supply of the same patient in different periods were compared and analyzed.The Limberg classification method was used to evaluate the activity.The results of colonoscopy in patients with IBD were followed up and compared with the results of ultrasound.Results Intestinal wall thickness was significantly greater in the active and remission phases of patients with IBD than that in the control group.The arterial resistance index in the observation group was significantly lower than that in the control group,but the difference in intestinal wall thickness and arterial resistance index between the menopausal and remission periods was not significant(P>0.05).12 cases of IBD active period and 18 cases of remission period were confirmed by endoscopy,and compared with ultrasound results.According to the endoscopic results,the coincidence rate of gray-scale ultrasound on the activity judgment of IBD patients was 100%.Conclusion Gray-scale ultrasound combined with energy Doppler ultrasound for the assessment of inflammatory bowel disease activity as an effective complement to endoscopy,can not only observe the intestinal wall thickness of the lesion,intestinal blood supply,etc.,and has important clinical guiding significance in monitoring the condition of patients with IBD and the adjustment of the treatment plan.