Radiographical evaluation of ulcerative colitis

Radiographical modalities have become important diagnostic tools in cases of ulcerative colitis(UC).Imaging can be used non-invasively to determine the extent of involvement,severity of disease and to detect disease-related complications and extra-intestinal inflammatory bowel disease(IBD)manifestations.While abdominal X-rays and barium enemas still retain their relevance in specific clinical settings,the use of computed tomography enterography(CTE)or magnetic resonance enterography(MRE)are now used as first-line investigations to exclude active small bowel disease in IBD patients and can be utilized to detect active colonic inflammation.Additionally,CT colonography and MR colonography are emerging techniques with potential applications in UC.Ultrasonography,leukocyte scintigraphy and positron emission tomography are novel abdominal imaging modalities currently being explored for IBD interrogations.This plethora of radiological imaging options has become a vital component of UC assessments.

一种联合肠道准备方案用于胶囊内镜检查:前瞻性随机对照研究

背景:胶囊内镜检查效果常受制于肠道内的食物残渣。本研究旨在评价一种联合肠道准备方安能否改善小肠视野,从而提高疾病诊断率和检查完成率。方法:本研究为前瞻性单盲随机对照研究,研究对象为在预约进行胶囊内镜检查的Mayo Clinic门诊患者。肠道准备组患者在胶囊内镜检查前夜饮用2 L聚乙二醇溶液,检查前20 min服用5mL西甲硅油和5mg胃复安,吞入胶囊内镜30 min后采用右侧卧位。对照组不做肠道准备,仅于检查前晚7点后禁食固体食物,检查前4 h内禁水。对所有研究对象进行满意度调查。胶囊内镜读片人员进行小肠视野评估。结果:前瞻性纳入50例患者,其中女性占56%,中位年龄54.4岁。44例完成研究,其中肠道准备组21例,对照组23例。两组患者在小肠四个分区中的视野清晰度的差异均无统计学意义(均P>0.05)。两组患者的疾病诊断率(P=0.69)、胃传输时间(P=0.10)和小肠传输时间(P=0.89)也均相当。肠道准备组的检查完成率显著高于对照组(100%vs 78%,P=0.02),但患者不适感也显著增多(62%vs 17%,P=0.01)。结论:联合肠道准备应用于胶囊内镜检查并没有改善小肠视野,却给患者带来了更多不适。尽管能提高检查完成率,但联合肠道准备并没有提高疾病检出率。因此,肠道准备似乎并不能改善胶囊内镜检查效果,反而会影响患者满意度。