中华生物医学工程杂志
中華生物醫學工程雜誌
중화생물의학공정잡지
CHINESE JOURNAL OF BIOMEDICAL ENGINEERING
2012年
1期
58-62
,共5页
胡英%吕鉴尧%黄欢雪%曾英玉
鬍英%呂鑒堯%黃歡雪%曾英玉
호영%려감요%황환설%증영옥
Crohn病%超声检查%超声检查,多普勒,彩色%对比增强超声%疾病活动度
Crohn病%超聲檢查%超聲檢查,多普勒,綵色%對比增彊超聲%疾病活動度
Crohn병%초성검사%초성검사,다보륵,채색%대비증강초성%질병활동도
Crohn' s disease%Ultrasonography%Ultrasonography,Doppler,color%Contrastenhanced ultrasonography%Disease activity
目的 探讨超声检测对克罗恩病内镜下疾病活动度的评估价值.方法 收集2009年3月至2011年3月在本院就诊或随访的克罗恩病患者62例,采用克罗恩病简单内镜下评分将疾病分为非活动性病变和活动性病变,然后分别通过普通超声检测病变肠壁厚度、彩色多普勒超声进行肠壁血流分级、对比增强超声定量获取肠壁感兴趣区(ROI)灰度值上升百分率.采用受试者工作特征曲线来评估上述3项指标对内镜下疾病活动度的评估价值.结果 内镜检查显示,62例克罗恩病患者中活动性病变44例,非活动性病变18例.活动性与非活动性克罗恩病患者超声检测显示肠壁厚度分别为(5.57± 1.73) mm和(4.38±2.16)mm,肠壁血流2～3级者分别有28例和3例,肠壁ROI灰度值上升百分率分别为(82±27)％和(40％±25)％,差异均有统计学意义(均P＜0.05).选择4.8 mm作为肠壁厚度的最佳截点,其评估内镜下克罗恩病活动度的敏感度、特异度和准确度分别为86.4％、66.7％和80.6％.肠壁血流分级评估内镜下克罗恩病活动度的敏感度、特异度和准确度分别为63.6％、83.3％和69.4％.选择55％作为肠壁ROI灰度值上升百分率的最佳截点,其评估内镜下克罗恩病活动度的敏感度、特异度和准确度分别为93.2％、83.3％和90.3％.结论 相比普通超声和彩色多普勒超声,对比增强超声的定量检测能够有效地将肠镜下不同活动度的克罗恩病区别开来,可作为评估克罗恩病患者疾病活动度的理想方法.
目的 探討超聲檢測對剋囉恩病內鏡下疾病活動度的評估價值.方法 收集2009年3月至2011年3月在本院就診或隨訪的剋囉恩病患者62例,採用剋囉恩病簡單內鏡下評分將疾病分為非活動性病變和活動性病變,然後分彆通過普通超聲檢測病變腸壁厚度、綵色多普勒超聲進行腸壁血流分級、對比增彊超聲定量穫取腸壁感興趣區(ROI)灰度值上升百分率.採用受試者工作特徵麯線來評估上述3項指標對內鏡下疾病活動度的評估價值.結果 內鏡檢查顯示,62例剋囉恩病患者中活動性病變44例,非活動性病變18例.活動性與非活動性剋囉恩病患者超聲檢測顯示腸壁厚度分彆為(5.57± 1.73) mm和(4.38±2.16)mm,腸壁血流2～3級者分彆有28例和3例,腸壁ROI灰度值上升百分率分彆為(82±27)％和(40％±25)％,差異均有統計學意義(均P＜0.05).選擇4.8 mm作為腸壁厚度的最佳截點,其評估內鏡下剋囉恩病活動度的敏感度、特異度和準確度分彆為86.4％、66.7％和80.6％.腸壁血流分級評估內鏡下剋囉恩病活動度的敏感度、特異度和準確度分彆為63.6％、83.3％和69.4％.選擇55％作為腸壁ROI灰度值上升百分率的最佳截點,其評估內鏡下剋囉恩病活動度的敏感度、特異度和準確度分彆為93.2％、83.3％和90.3％.結論 相比普通超聲和綵色多普勒超聲,對比增彊超聲的定量檢測能夠有效地將腸鏡下不同活動度的剋囉恩病區彆開來,可作為評估剋囉恩病患者疾病活動度的理想方法.
목적 탐토초성검측대극라은병내경하질병활동도적평고개치.방법 수집2009년3월지2011년3월재본원취진혹수방적극라은병환자62례,채용극라은병간단내경하평분장질병분위비활동성병변화활동성병변,연후분별통과보통초성검측병변장벽후도、채색다보륵초성진행장벽혈류분급、대비증강초성정량획취장벽감흥취구(ROI)회도치상승백분솔.채용수시자공작특정곡선래평고상술3항지표대내경하질병활동도적평고개치.결과 내경검사현시,62례극라은병환자중활동성병변44례,비활동성병변18례.활동성여비활동성극라은병환자초성검측현시장벽후도분별위(5.57± 1.73) mm화(4.38±2.16)mm,장벽혈류2～3급자분별유28례화3례,장벽ROI회도치상승백분솔분별위(82±27)％화(40％±25)％,차이균유통계학의의(균P＜0.05).선택4.8 mm작위장벽후도적최가절점,기평고내경하극라은병활동도적민감도、특이도화준학도분별위86.4％、66.7％화80.6％.장벽혈류분급평고내경하극라은병활동도적민감도、특이도화준학도분별위63.6％、83.3％화69.4％.선택55％작위장벽ROI회도치상승백분솔적최가절점,기평고내경하극라은병활동도적민감도、특이도화준학도분별위93.2％、83.3％화90.3％.결론 상비보통초성화채색다보륵초성,대비증강초성적정량검측능구유효지장장경하불동활동도적극라은병구별개래,가작위평고극라은병환자질병활동도적이상방법.
Objective To investigate the evaluation value ofultrasonography (US) on the activity of Crohn' s disease under endoscopy.Methods A total of 62 cases with Crohn' s disease in our hospital from March 2009 to March 2011 were enrolled in the study.Crohn' s disease was grouped as inactive and active by colonoscopy using Simplified Endoscopic Scoring,mural thickness of the intestine being involved was assessed via conventional US,bowel wall vascularity was graded using color Doppler US,and the percentage of increase in bowel wall brightness in regions of interest (ROI) was acquired quantitatively through contrast-enhanced US.Receiver operating characteristic curve was applied to evaluate the value of parameters above in assessing the disease activity as determined by endoscopy.Results Of 62 subjects with Crohn' s disease,colonoscopy showed active lesions in 44 cases and inactive lesions in 18 cases,whose intestinal mural thickness was (5.57± 1.73) mm and (4.38±2.16) mm,the number of cases with grade 2-3 vascularity was 28 and 3,and the percentage of increase in ROI brightness was (82±27)％ and (40％±25)％,respectively (all P＜0.05 ).A optimal cut-off value of 4.8nun for intestinal mural thickness was determined,with the sensitivity,specificity and accuracy for assessing the disease activity under endoscopy of 86.4％,66.7％ and 80.6％,respectively.And the sensitivity,specificity and accuracy for assessing the disease activity under endoscopy using grading of intestinal wall vascularity were 63.6％,83.3％ and 69.4％,respectively.There was a sensitivity of 93.2％,specificity of 83.3％,and accuracy of 90.3％ in identifying patients with disease activity as measured by endoscopy using the optimal cut-off value of 55％ for the percentage of increase in ROI brightness.Conclusions As compared with conventional US and color Doppler US,quantitative measurement by using contrast-enhanced US is of higher effectiveness in classifying the severity and may be a useful tool to evaluate the activity of Crohn' s disease.
