肠壁厚度截止值用于评估炎症性肠病活动使用小孩肠道超声波
Laura Räisänen1,2,3, Ray Lang3, Michael Couper4
1Tampere Center for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University , Tampere, Finland.
Inflammatory bowel diseases
|December 8, 2025
概括
肠道超声波 (IUS) 是评估儿科肠道炎症的一个有价值的工具. 建议对儿童进行新的肠壁厚度 (BWT) 切断,因为成人标准错过了显著的炎症.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 诊断成像 诊断成像 诊断成像
- 炎症性肠道疾病是什么
背景情况:
- 肠道超声波 (IUS) 是一种评估肠道炎症的非侵入性方法.
- 在成年人中使用0.30厘米的标准肠壁厚度 (BWT) 截止值,但缺少儿科特定值.
- 准确评估儿科肠道炎症对于及时诊断和治疗至关重要.
研究的目的:
- 为了确定最佳的BWT切割值来检测使用IUS的儿童的肠道炎症.
- 在儿童群体中比较成人BWT切线的诊断准确性.
- 根据年龄,性别或体重来确定最佳BWT切断的潜在差异.
主要方法:
- 在结肠镜检查前30天或结肠镜检查后7天内,对133名儿童进行了144次IUS检查.
- 从终端大肠到直肠的肠壁厚度 (BWT) 测量与结肠镜检查结果 (809个配对段) 相对相关.
- 用接收器操作特征 (ROC) 分析来确定最佳的BWT切断点来检测炎症.
主要成果:
- 在6岁以上的儿童中,IUS对中度/重度炎症具有很高的准确性 (AUC 0.907),但对轻度炎症 (AUC 0.690) 或6岁以下的儿童 (AUC 0.667) 的准确性较低.
- 成人的BWT切线为0.30厘米,错过了32%的儿童炎症.
- 在6岁以上的儿童中,BWT切线0.27厘米检测到85%的中度/重度炎症和43%的轻度炎症;较低的切线 (0.24厘米) 对女孩和40公斤以下的儿童来说更好.
结论:
- IUS对中度/严重的儿科肠道炎症有效,但在6岁以下的儿童中不那么准确.
- 成人BWT切线对于儿童来说是不理想的,缺少超过30%的炎症病例.
- 建议的BWT切断范围为男孩0.27-0.30厘米,女孩0.23-0.25厘米和/或儿童<40公斤,以表明活跃的肠道炎症.
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