中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2011年
9期
582-586
,共5页
冉志华%钱孝先%沈骏%黄美兰%王天蓉
冉誌華%錢孝先%瀋駿%黃美蘭%王天蓉
염지화%전효선%침준%황미란%왕천용
超声检查%克罗恩病%肛门疾病%脓肿%直肠瘘%磁共振成像%骨盆
超聲檢查%剋囉恩病%肛門疾病%膿腫%直腸瘺%磁共振成像%骨盆
초성검사%극라은병%항문질병%농종%직장루%자공진성상%골분
Ultrasonography%Crohn's disease%Anusdiseases%Abscess%Rectal fistula%Magnetic resonance imaging%Pelvis
目的 分析经皮肛周超声(transcutaneous perianal ultrasonography，TPUS)与盆腔磁共振(magnetic resonance imaging，MRI)诊断克罗恩病肛周病变的一致性，评价TPUS诊断克罗恩病肛周病变的价值。方法 连续性纳入2008年8月至2010年8月期间确诊为克罗恩病的患者102例，采用超声及MRI系统分别诊断克罗恩病患者肛周脓肿和瘘管的情况。应用统计软件SPSS 11.5进行X2检验，以Kappa检验进行一致性分析。结果 克罗恩病肛周病变的起病时间平均为典型症状出现的-0.443年（95％CI：-1.659～0.773年）。使用TPUS和盆腔MRI诊断肛周病变无显著的统计学差异（P＝0.706,Kappa＝0.541）。如以盆腔MRI作为诊断肝周脓肿和瘘管的金标准，则得出TPUS诊断诊断肛周病变的灵敏度为72.73％，特异度为82.61％,Youden指数为0.55,阳性预测值为66.67％，阴性预测值为86.36％。TPUS和盆腔MRI诊断肛周脓肿(P＝0.706，Kappa＝0.496)及肛周瘘管（P＝0.655，Kappa＝0.546）差异均无统计学意义。结论 肛周病变可以出现在克罗恩病发病的整个病程中，利用TPUS诊断克罗恩病的肛周脓肿和瘘管与盆腔MRI相比具有良好的一致性,TPUS可作为诊断及评估克罗恩病的肛周病变的辅助方法。
目的 分析經皮肛週超聲(transcutaneous perianal ultrasonography，TPUS)與盆腔磁共振(magnetic resonance imaging，MRI)診斷剋囉恩病肛週病變的一緻性，評價TPUS診斷剋囉恩病肛週病變的價值。方法 連續性納入2008年8月至2010年8月期間確診為剋囉恩病的患者102例，採用超聲及MRI繫統分彆診斷剋囉恩病患者肛週膿腫和瘺管的情況。應用統計軟件SPSS 11.5進行X2檢驗，以Kappa檢驗進行一緻性分析。結果 剋囉恩病肛週病變的起病時間平均為典型癥狀齣現的-0.443年（95％CI：-1.659～0.773年）。使用TPUS和盆腔MRI診斷肛週病變無顯著的統計學差異（P＝0.706,Kappa＝0.541）。如以盆腔MRI作為診斷肝週膿腫和瘺管的金標準，則得齣TPUS診斷診斷肛週病變的靈敏度為72.73％，特異度為82.61％,Youden指數為0.55,暘性預測值為66.67％，陰性預測值為86.36％。TPUS和盆腔MRI診斷肛週膿腫(P＝0.706，Kappa＝0.496)及肛週瘺管（P＝0.655，Kappa＝0.546）差異均無統計學意義。結論 肛週病變可以齣現在剋囉恩病髮病的整箇病程中，利用TPUS診斷剋囉恩病的肛週膿腫和瘺管與盆腔MRI相比具有良好的一緻性,TPUS可作為診斷及評估剋囉恩病的肛週病變的輔助方法。
목적 분석경피항주초성(transcutaneous perianal ultrasonography，TPUS)여분강자공진(magnetic resonance imaging，MRI)진단극라은병항주병변적일치성，평개TPUS진단극라은병항주병변적개치。방법 련속성납입2008년8월지2010년8월기간학진위극라은병적환자102례，채용초성급MRI계통분별진단극라은병환자항주농종화루관적정황。응용통계연건SPSS 11.5진행X2검험，이Kappa검험진행일치성분석。결과 극라은병항주병변적기병시간평균위전형증상출현적-0.443년（95％CI：-1.659～0.773년）。사용TPUS화분강MRI진단항주병변무현저적통계학차이（P＝0.706,Kappa＝0.541）。여이분강MRI작위진단간주농종화루관적금표준，칙득출TPUS진단진단항주병변적령민도위72.73％，특이도위82.61％,Youden지수위0.55,양성예측치위66.67％，음성예측치위86.36％。TPUS화분강MRI진단항주농종(P＝0.706，Kappa＝0.496)급항주루관（P＝0.655，Kappa＝0.546）차이균무통계학의의。결론 항주병변가이출현재극라은병발병적정개병정중，이용TPUS진단극라은병적항주농종화루관여분강MRI상비구유량호적일치성,TPUS가작위진단급평고극라은병적항주병변적보조방법。
Objective To analyze the consistency of transcutaneous perianal ultrasonography (TPUS) and pelvic magnetic resonance imaging (MRI) in diagnosing perianal lesions of Crohn's disease (CD), and to evaluate the value of transcutaneous perianal ultrasonography in detecting perianal lesions of CD. Methods A cohort of 102 patients diagnosed as Corhn's disease were enrolled from August 2008 to August 2010. Perianal abscess and fistula of these CD patients was diagnosed by ultrasonography and MRI system. Statistics was performed with SPSS 11.5 software for X2 test. The consistency was analyzed with Kappa test. Results The mean onset time of perianal lesions in CD was -0.443 year (95％CI:-1.659～0.773 year) before typical symptoms showed up. There was no significant difference in detecting perianal lesions of CD between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging (P ＝ 0.706, Kappa ＝ 0.541). If pelvic magnetic resonance imaging was considered as the golden standard in detecting perianal lesions of CD,the sensitivity (Sen), specificity (Spe), Youden's index, positive predictive value (PPV) and negative predictive value (NPV) of TPUS were 72.73％, 82.61％, 0.55, 66.67％ and 86.36％ respectively.Furthermore, there was no significant difference between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging in detecting perianal abscess ( P ＝ 0.706, Kappa ＝ 0.496) and fistula (P＝0.655, Kappa＝0.546) of CD. Conclusions Perianal lesions occur in the entire course of CD. There was favorable consistency between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging in detecting perianal abscess and fistula of CD. Transcutaneous perianal ultrasonography can be used as an additional method in detecting and evaluting perianal lesions of CD.
