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Atul Kapoor1, Anil Singh2, Aprajita Kapur1
1Department of Radiology, Advanced Diagnostics and Institute of Imaging, Amritsar, Punjab, India.
剪切波弹性图 (SWE) 和肠道超声波 (IUS) 准确地区分炎症和纤维性肠狭窄. 与对比度增强计算机断层扫描 (CECT) 相比,这种综合方法提供了更高的诊断准确性.
科学领域:
- 胃肠病学 胃肠病学
- 医疗成像医学成像
- 诊断性的超声波检查
背景情况:
- 区分炎症性和纤维性肠收缩对于有效的患者管理至关重要.
- 传统的成像方法,如对比增强计算机断层扫描 (CECT),在精确的表征方面存在局限性.
- 新型超声波技术有可能提高诊断准确度.
研究的目的:
- 评估剪切波弹性图 (SWE) 和肠道超声波 (IUS) 在区分炎症和纤维性肠狭窄的作用.
- 确定扬模量 (E) 和剪波分散 (SWD) 用于表征收窄.
- 在患有慢性胃肠道症状的患者中,将SWE和IUS与CECT的诊断性能进行比较.
主要方法:
- 一项回顾性研究,涉及76名患者,他们的小肠壁加厚 (SBWT>3毫米) 或大肠壁 (LBWT>4毫米) 在IUS上.
- 用SWE和分散分析将患者分为纤维化,炎症或混合组.
- 使用IUS灰度特征进一步细化病因诊断,并与CECT发现进行比较;活检或手术证实了41名患者的诊断.
主要成果:
- 结合SWE和IUS方法实现了100%的灵敏度和99%的特异性,接收器操作特征曲线 (AUROC) 下的面积为100%.
- 纤维性狭窄 (I组) 主要是由于克罗恩氏病 (CD) 和结核病,而炎症性狭窄 (II组) 主要是感染性大肠炎和性大肠炎.
- CECT表现出较低的灵敏度 (78%) 和特异性 (96%),AUROC为64%.
结论:
- 结合SWE和IUS在两步方法中准确评估肠壁加厚的患者,区分炎症和纤维变化.
- 这种方法有助于形成慢性腹和腹痛的病因诊断.
- 与CECT相比,SWE和IUS技术的结合提供了优越的诊断性能,用于肠道狭窄的特征.
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