动态对比增强超声波在评估克罗恩病活动中的应用
Ying Wang1, Li Wei1, Wen-Song Ge2
1Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China.
动态对比增强超声波 (DCE-US) 显示出评估克罗恩病 (CD) 活动的前景. 这种非侵入性成像技术使用定量输液参数准确识别活跃疾病,有助于患者的随访.
科学领域:
- 胃肠病学 胃肠病学
- 医疗成像医学成像
- 放射学 放射学是一门学科.
背景情况:
- 在患者随访期间评估克罗恩病 (CD) 活动是一个重大的临床挑战.
- 动态对比增强超声波 (DCE-US) 为评估疾病状况提供了一个潜在的非侵入性成像模式.
研究的目的:
- 调查DCE-US在评估克罗恩病活动中的有效性.
- 确定从DCE-US获得的定量 perfusion 参数,以区分活性和非活性 CD.
主要方法:
- 一项回顾性研究包括52名被诊断患有CD的患者,由临床症状和胆管结肠镜检查证实.
- 进行了肠道超声波和DCE-US检查,并分析了时间强度曲线 (TIC) 和定量 perfusion 参数.
- 克罗恩病简单内镜评分 (SES-CD) 作为参考标准;ROC分析确定了诊断效率.
主要成果:
- 活跃的CD患者 (n=39) 与不活跃的CD患者 (n=13) 相比,显示出明显更高的DCE-US定量参数,包括峰值增强 (PE),曲线下的洗进面积 (WiAUC),洗进率 (WiR),洗进输液指数 (WiPI) 和洗出率 (WoR) (p <0.05).
- 超声波特征,如肠壁厚度>4.2毫米和中肠脂肪增大,在活跃的CD中很常见.
- 对肠道超声波特征和DCE-US参数的综合分析实现了0.987的AUROC,具有97.4%的灵敏度,100%的特异性和98.1%的准确性来诊断活性CD.
结论:
- 使用定量 perfusion 参数的 DCE-US 证明了其作为评估克罗恩病活动的宝贵的非侵入性成像工具的潜力.
- 这种方法提供了高的诊断准确性,支持其在常规临床实践中用于CD管理.
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