This article extends on the use of transabdominal intestinal ultrasound in diagnosing pediatric inflammatory bowel disease.Some of the more essential features used in assessing bowel inflammation,such as hyperemia and...This article extends on the use of transabdominal intestinal ultrasound in diagnosing pediatric inflammatory bowel disease.Some of the more essential features used in assessing bowel inflammation,such as hyperemia and wall thickness on ultrasound,are expanded upon from the publication on imaging and endoscopic tools in pediatric inflammatory bowel disease.展开更多
目的探讨小儿肠套叠空气整复与肠壁肿胀厚度之间的关系。方法对61例肠套叠经彩色多普勒 B 超检查,测量套叠肠壁肿胀的厚度并记录,然后根据测量数据,按肠壁肿胀厚度,选择不同的空气压力进行整复。结果整复成功52例,占85%;失败9例,占15%...目的探讨小儿肠套叠空气整复与肠壁肿胀厚度之间的关系。方法对61例肠套叠经彩色多普勒 B 超检查,测量套叠肠壁肿胀的厚度并记录,然后根据测量数据,按肠壁肿胀厚度,选择不同的空气压力进行整复。结果整复成功52例,占85%;失败9例,占15%。肠套叠空气整复成功与否与患儿的性别及肠套叠部位无明显关系,与肿胀肠壁厚度、空气压力有关。空气整复可行性的标准:当水肿肠壁厚度<1.1cm、选择空气压力8～15kPa,可以空气整复;当水肿肠壁厚度在1.1～1.5cm、选择空气压力8～13kPa,可.以谨慎地进行空气整复;当水肿肠壁厚度>1.5cm、空气压力不超过8kPa,只作诊断,不宜进行空气整复,否则有穿孔的危险。结论小儿肠套叠空气整复成功与否,与肠壁肿胀厚度有明显关系,这对小儿肠套叠选择性地空气整复具有很高的指导价值。展开更多
AIM： To evaluate computed tomography （CT） findings, useful to suggest the presence of refractory celiac disease （RCD） and enteropathy associated T cell lymphoma （EATL）. METHODS： Coeliac disease （CD） patients...AIM： To evaluate computed tomography （CT） findings, useful to suggest the presence of refractory celiac disease （RCD） and enteropathy associated T cell lymphoma （EATL）. METHODS： Coeliac disease （CD） patients were divided into two groups. Group Ⅰ ： uncomplicated CD （n = 14） and RCD type Ⅰ （n = 10）. Group Ⅱ ： RCD type Ⅱ （n = 15） and EATL （n = 7）. RESULTS： Both groups showed classic signs of CD on CT. Intussusception was seen in 1 patient in group Ⅰ vs 5 in group Ⅱ （P = 0.06）. Lymphadenopathy was seen in 5 patients in group Ⅱ vs no patients in group Ⅰ （P = 0.01）. Increased number of small mesenteric vessels was noted in 20 patients in group Ⅰ vs Ⅱ in group 11 （P = 0.02）. Eleven patients （50%） in group 11 had a splenic volume 〈 122 cm^3 vs 4 in group Ⅰ （14%）, 10 patients in group Ⅰ had a splenic volume 〉 196 cm^3 （66.7%） vs 5 in group Ⅱ （33.3%） P = 0.028. CONCLUSION： CT scan is a useful tool in discriminating between CD and （Pre） EATL. RCD Ⅱ and EATL showed more bowel wall thickening, lymphadenopathy and intussusception, less increase in number of small mesenteric vessels and a smaller splenic volume compared with CD and RCD Ⅰ.展开更多
AIM： To investigate the sonographic features at time of diagnosis and follow-up in patients with neutropenic enterocolitis. METHODS： The sonographic findings in 14 patients with neutropenic enterocolitis were descri...AIM： To investigate the sonographic features at time of diagnosis and follow-up in patients with neutropenic enterocolitis. METHODS： The sonographic findings in 14 patients with neutropenic enterocolitis were described and evaluated regarding symptoms and clinical outcome. RESULTS： In all patients with neutropenic enterocolitis, the ileocoecal region was involved with wall thickening 〉10 mm. A transmural inflammatory pattern, hypervascularity of the thickened bowel wall and free abdominal fluid were the common findings. The sonographically revealed thickness of the bowel wall was associated with lethal outcome （P〈0.03）. In the 11 surviving patients, the improvement of clinical symptoms was accompanied by progressive reduction of intestinal wall thickness. CONCLUSION： High-end sonography of the bowel is a helpful tool for diagnosis, assessment of prognosis and follow-up of patients with neutropenic enterocolitis. The ultrasonographically revealed bowel thickness reflects the severity and the course of the disease, and seems to be predictive for the clinical outcome.展开更多
The majority of patients affected by Crohn’s disease(CD)develop a chronic condition with persistent inflammation and relapses that may cause progressive and irreversible damage to the bowel,resulting in stricturing o...The majority of patients affected by Crohn’s disease(CD)develop a chronic condition with persistent inflammation and relapses that may cause progressive and irreversible damage to the bowel,resulting in stricturing or penetrating complications in around 50%of patients during the natural history of the disease.Surgery is frequently needed to treat complicated disease when pharmacological therapy failes,with a high risk of repeated operations in time.Intestinal ultrasound(IUS),a non-invasive,cost-effective,radiation free and reproducible method for the diagnosis and follow-up of CD,in expert hands,allow a precise assessment of all the disease manifestations:Bowel characteristics,retrodilation,wrapping fat,fistulas and abscesses.Moreover,IUS is able to assess bowel wall thickness,bowel wall stratification(echo-pattern),vascularization and elasticity,as well as mesenteric hypertrophy,lymph-nodes and mesenteric blood flow.Its role in the disease evaluation and behaviour description is well assessed in literature,but less is known about the potential space of IUS as predictor of prognostic factors suggesting response to a medical treatment or postoperative recurrence.The availability of a low cost exam as IUS,able to recognize which patients are more likely to respond to a specific therapy and which patients are at high risk of surgery or complications,could be a very useful instrument in the hands of IBD physician.The aim of this review is to present current evidence about the prognostic role that IUS can show in predicting response to treatment,disease progression,risk of surgery and risk of post-surgical recurrence in CD.展开更多
目的:探讨肠壁增厚和密度计算机断层扫描(computed tomography,CT)影像特征变化对小肠梗阻的诊断价值,为肠梗阻的诊断提供临床可参考依据.方法:共纳入42例河南省南阳市中心医院确诊为单纯性小肠梗阻(simple small bowel obstruction,SI)...目的:探讨肠壁增厚和密度计算机断层扫描(computed tomography,CT)影像特征变化对小肠梗阻的诊断价值,为肠梗阻的诊断提供临床可参考依据.方法:共纳入42例河南省南阳市中心医院确诊为单纯性小肠梗阻(simple small bowel obstruction,SI)及38例确诊为绞窄性小肠梗阻(strangulated small bowel obstruction,ST)的患者作为研究对象,所有患者均行CT平扫及增强检查,记录CT显示肠壁增厚密度,评价不同密度对不同类型小肠梗阻的诊断价值.结果:平扫时SI患者内层密度正常比例明显高于ST患者,而全层密度减低比例低于ST患者,差异有统计学意义(P<0.05);增强扫描时ST患者全层密度减低比例高于SI患者,差异有统计学意义(P<0.05).平扫内层密度正常诊断ST的灵敏度为34.2%,特异度为33.3%;平扫全层密度减低的灵敏度为73.7%,特异度为71.4%;增强全层密度减低的灵敏度为84.2%,特异度为73.8%.结论:增强CT显示小肠壁全层密度减低更多倾向于考虑ST,对于该类患者在知情同意的前提下可及早手术治疗.展开更多
Over the recent years the non-invasive techniques for the evaluation of the small bowel have been playing a major role in the management of chronic intestinal diseases, such as inflammatory bowel diseases(IBD). The di...Over the recent years the non-invasive techniques for the evaluation of the small bowel have been playing a major role in the management of chronic intestinal diseases, such as inflammatory bowel diseases(IBD). The diagnostic performances of magnetic resonance imaging, computed tomography and ultrasound in the field of small bowel disorders, have been assessed and established for more than two decades. Newer sonographic techniques, such as strain elastography and shear wave elastography, have been put forward for the assessment of disease activity and characterization of IBD-related damage in the setting of Crohn's disease and other gastrointestinal disorders. The data from the preliminary research and clinical studies have shown promising results as regards the ability of elastographic techniques to differentiate inflammatory from fibrotic tissue. The distinction between IBD activity(inflammation) and IBD-related damage(fibrosis) is currently considered crucial for the assessment and management of patients. Moreover, all the elastographic techniques are currently being considered in the setting of other intestinal disorders(e.g., rectal tumors, appendicitis). The aim of this paper is to offer both a comprehensive narrative review of the non-invasive techniques available for the assessment of small-bowel disorders, with particular emphasis on inflammatory bowel diseases, and a summary of the current evidence on the use of elastographic techniques in this setting.展开更多
文摘This article extends on the use of transabdominal intestinal ultrasound in diagnosing pediatric inflammatory bowel disease.Some of the more essential features used in assessing bowel inflammation,such as hyperemia and wall thickness on ultrasound,are expanded upon from the publication on imaging and endoscopic tools in pediatric inflammatory bowel disease.
文摘目的探讨小儿肠套叠空气整复与肠壁肿胀厚度之间的关系。方法对61例肠套叠经彩色多普勒 B 超检查,测量套叠肠壁肿胀的厚度并记录,然后根据测量数据,按肠壁肿胀厚度,选择不同的空气压力进行整复。结果整复成功52例,占85%;失败9例,占15%。肠套叠空气整复成功与否与患儿的性别及肠套叠部位无明显关系,与肿胀肠壁厚度、空气压力有关。空气整复可行性的标准:当水肿肠壁厚度<1.1cm、选择空气压力8～15kPa,可以空气整复;当水肿肠壁厚度在1.1～1.5cm、选择空气压力8～13kPa,可.以谨慎地进行空气整复;当水肿肠壁厚度>1.5cm、空气压力不超过8kPa,只作诊断,不宜进行空气整复,否则有穿孔的危险。结论小儿肠套叠空气整复成功与否,与肠壁肿胀厚度有明显关系,这对小儿肠套叠选择性地空气整复具有很高的指导价值。
文摘AIM： To evaluate computed tomography （CT） findings, useful to suggest the presence of refractory celiac disease （RCD） and enteropathy associated T cell lymphoma （EATL）. METHODS： Coeliac disease （CD） patients were divided into two groups. Group Ⅰ ： uncomplicated CD （n = 14） and RCD type Ⅰ （n = 10）. Group Ⅱ ： RCD type Ⅱ （n = 15） and EATL （n = 7）. RESULTS： Both groups showed classic signs of CD on CT. Intussusception was seen in 1 patient in group Ⅰ vs 5 in group Ⅱ （P = 0.06）. Lymphadenopathy was seen in 5 patients in group Ⅱ vs no patients in group Ⅰ （P = 0.01）. Increased number of small mesenteric vessels was noted in 20 patients in group Ⅰ vs Ⅱ in group 11 （P = 0.02）. Eleven patients （50%） in group 11 had a splenic volume 〈 122 cm^3 vs 4 in group Ⅰ （14%）, 10 patients in group Ⅰ had a splenic volume 〉 196 cm^3 （66.7%） vs 5 in group Ⅱ （33.3%） P = 0.028. CONCLUSION： CT scan is a useful tool in discriminating between CD and （Pre） EATL. RCD Ⅱ and EATL showed more bowel wall thickening, lymphadenopathy and intussusception, less increase in number of small mesenteric vessels and a smaller splenic volume compared with CD and RCD Ⅰ.
文摘AIM： To investigate the sonographic features at time of diagnosis and follow-up in patients with neutropenic enterocolitis. METHODS： The sonographic findings in 14 patients with neutropenic enterocolitis were described and evaluated regarding symptoms and clinical outcome. RESULTS： In all patients with neutropenic enterocolitis, the ileocoecal region was involved with wall thickening 〉10 mm. A transmural inflammatory pattern, hypervascularity of the thickened bowel wall and free abdominal fluid were the common findings. The sonographically revealed thickness of the bowel wall was associated with lethal outcome （P〈0.03）. In the 11 surviving patients, the improvement of clinical symptoms was accompanied by progressive reduction of intestinal wall thickness. CONCLUSION： High-end sonography of the bowel is a helpful tool for diagnosis, assessment of prognosis and follow-up of patients with neutropenic enterocolitis. The ultrasonographically revealed bowel thickness reflects the severity and the course of the disease, and seems to be predictive for the clinical outcome.
文摘The majority of patients affected by Crohn’s disease(CD)develop a chronic condition with persistent inflammation and relapses that may cause progressive and irreversible damage to the bowel,resulting in stricturing or penetrating complications in around 50%of patients during the natural history of the disease.Surgery is frequently needed to treat complicated disease when pharmacological therapy failes,with a high risk of repeated operations in time.Intestinal ultrasound(IUS),a non-invasive,cost-effective,radiation free and reproducible method for the diagnosis and follow-up of CD,in expert hands,allow a precise assessment of all the disease manifestations:Bowel characteristics,retrodilation,wrapping fat,fistulas and abscesses.Moreover,IUS is able to assess bowel wall thickness,bowel wall stratification(echo-pattern),vascularization and elasticity,as well as mesenteric hypertrophy,lymph-nodes and mesenteric blood flow.Its role in the disease evaluation and behaviour description is well assessed in literature,but less is known about the potential space of IUS as predictor of prognostic factors suggesting response to a medical treatment or postoperative recurrence.The availability of a low cost exam as IUS,able to recognize which patients are more likely to respond to a specific therapy and which patients are at high risk of surgery or complications,could be a very useful instrument in the hands of IBD physician.The aim of this review is to present current evidence about the prognostic role that IUS can show in predicting response to treatment,disease progression,risk of surgery and risk of post-surgical recurrence in CD.
文摘目的:探讨肠壁增厚和密度计算机断层扫描(computed tomography,CT)影像特征变化对小肠梗阻的诊断价值,为肠梗阻的诊断提供临床可参考依据.方法:共纳入42例河南省南阳市中心医院确诊为单纯性小肠梗阻(simple small bowel obstruction,SI)及38例确诊为绞窄性小肠梗阻(strangulated small bowel obstruction,ST)的患者作为研究对象,所有患者均行CT平扫及增强检查,记录CT显示肠壁增厚密度,评价不同密度对不同类型小肠梗阻的诊断价值.结果:平扫时SI患者内层密度正常比例明显高于ST患者,而全层密度减低比例低于ST患者,差异有统计学意义(P<0.05);增强扫描时ST患者全层密度减低比例高于SI患者,差异有统计学意义(P<0.05).平扫内层密度正常诊断ST的灵敏度为34.2%,特异度为33.3%;平扫全层密度减低的灵敏度为73.7%,特异度为71.4%;增强全层密度减低的灵敏度为84.2%,特异度为73.8%.结论:增强CT显示小肠壁全层密度减低更多倾向于考虑ST,对于该类患者在知情同意的前提下可及早手术治疗.
文摘Over the recent years the non-invasive techniques for the evaluation of the small bowel have been playing a major role in the management of chronic intestinal diseases, such as inflammatory bowel diseases(IBD). The diagnostic performances of magnetic resonance imaging, computed tomography and ultrasound in the field of small bowel disorders, have been assessed and established for more than two decades. Newer sonographic techniques, such as strain elastography and shear wave elastography, have been put forward for the assessment of disease activity and characterization of IBD-related damage in the setting of Crohn's disease and other gastrointestinal disorders. The data from the preliminary research and clinical studies have shown promising results as regards the ability of elastographic techniques to differentiate inflammatory from fibrotic tissue. The distinction between IBD activity(inflammation) and IBD-related damage(fibrosis) is currently considered crucial for the assessment and management of patients. Moreover, all the elastographic techniques are currently being considered in the setting of other intestinal disorders(e.g., rectal tumors, appendicitis). The aim of this paper is to offer both a comprehensive narrative review of the non-invasive techniques available for the assessment of small-bowel disorders, with particular emphasis on inflammatory bowel diseases, and a summary of the current evidence on the use of elastographic techniques in this setting.
