超声造影联合定量分析参数对炎症性肠病活动性诊断及治疗的临床指导价值

Contrast-enhanced ultrasound combined quantitative analysis of the parameters of clinical guidance value in the diagnosis and treatment of inflammatory bowel disease activity

目的 研究联合应用超声造影(CEUS)及定量分析参数对炎症性肠病(IBD)炎症活动性的诊断效果。方法 选择2021年11月—2022年8月蚌埠医学院第一附属医院消化内科收治的住院IBD患者以及门诊随诊的IBD患者共27例,结合病理及临床诊断分成溃疡性结肠炎(UC组,13例)及克罗恩病(CD组,14例),依据CD活动指数评分表及改良Mayo量表,分别将2组患者分为活动组与非活动组,再分别比较活动组与非活动组患者肠壁的厚度,能量多普勒(PDI)血流情况、CEUS强化模式及定量参数[峰值强度(PI)、上升支斜率(AS)、到达时间(AT)、达峰时间(TTP)]。结果 溃疡性结肠炎活动组患者的肠壁厚度均高于非活动组[(8.4±1.3)mm vs.(5.2±1.0)mm,t=4.810,P=0.001],克罗恩病活动组患者的肠壁厚度均高于非活动组[(8.2±1.8)mm vs.(5.1±1.2)mm,t=3.850,P=0.002]。溃疡性结肠炎活动与非活动组患者肠壁血流分级及CEUS强化模式比较差异有统计学意义(均P<0.05)。溃疡性结肠炎活动与非活动组患者PI、AT比较差异有统计学意义(均P<0.05);克罗恩病活动与非活动组患者PI、TTP比较差异有统计学意义(均P<0.05)。结论 肠壁厚度、PDI、CEUS强化方式及定量参数PI、AT、TTP均与炎症性肠病活动性的诊断与评估相关。

Objective To study the effectiveness of the combined use of contrast-enhanced ultrasound(CEUS)and quantitative analysis parameters for the diagnosis of inflammatory bowel disease(IBD)in terms of inflammatory activity.Methods A total of 27 inpatients with IBD admitted to the Department of Gastroenterology of the First Affiliated Hospital of Bengbu Medical College and the outpatient follow-up IBD patients were selected from November 2021 to August 2022.They were divided into ulcerative colitis(UC group,13 cases)and Crohn's disease(CD group,14 cases)groups according to their pathology and clinical diagnosis.According to the CD activity index score and the modified Mayo scale,the two groups of patients were divided into active and inactive groups.Intestinal wall thickness,power Doppler image(PDI)blood flow,CEUS enhancement mode and quantitative parameters[peak intensity(PI),ascending slope(AS),arrival time(AT),time to peak(TTP)]were compared between active and inactive groups.Results The intestinal wall thickness in the active group of UC was greater than that in the inactive group[(8.4±1.3)mm vs.(5.2±1.0)mm,t=4.810,P=0.001].The intestinal wall thickness in the active group of CD was greater than that in the inactive group[(8.2±1.8)mm vs.(5.1±1.2)mm,t=3.850,P=0.002].There were significant differences in the grading of intestinal wall blood flow and the enhancement pattern of CEUS between the active and inactive UC groups(all P<0.05).There were significant differences in PI and AT between the active and inactive UC groups(both P<0.05).There were significant differences in PI and TTP between the active and inactive CD groups(both P<0.05).Conclusion The intestinal wall thickness,PDI,CEUS enhancement pattern and the quantitative analysis parameters PI,AT and TTP are all relevant to the diagnosis and assessment of inflammatory bowel disease activity.