Prantera C, Lorenzetti R, Cerro P, Davoli M, Brancato G, Fanucci A
Division of Gastroenterology, Ospedale Nuovo Regina Margherita, Rome, Italy.
J Clin Gastroenterol. 1991 Apr;13(2):231-4. doi: 10.1097/00004836-199104000-00024.
The aim of our study was to establish whether plain abdominal film can accurately assess the extent of active ulcerative colitis. Ninety-seven ulcerative colitis patients were studied, in whom the extent of the macroscopic lesion was established either by colonoscopy (n = 75) or by resection (n = 22). Of these, 42 had proctosigmoiditis, 12 left-sided colitis, 12 subtotal colitis, and 31 total colitis. Nine well-tested features were used for the radiological classification of lesion extent. The radiologists were not given any clinical information. Seventy-eight patients (80.4%) were correctly classified by plain abdominal film (r = 0.86); the best concordance was achieved for proctosigmoiditis and total colitis (80.9 and 90.3%, respectively). In total colitis the most reliable radiological features were "irregularity of the mucosal edge" and "increased thickness of the colon wall, " which were present in 74.2 and 67.7%, respectively, of the correctly classified patients. The fourfold combination of these two features with "loss of haustral clefts" and "empty right colon" was present only in patients with total colitis, and at least one of these features was present in all but one of them. Conversely, all nine abnormalities were absent in 73.8% of patients with proctosigmoiditis. In conclusion, plain abdominal film is a reliable tool for judging the extent of lesion in active ulcerative colitis. It seems particularly accurate in total colitis, where, in the acute phases, it is most important to avoid invasive examinations.
我们研究的目的是确定腹部平片能否准确评估活动期溃疡性结肠炎的病变范围。对97例溃疡性结肠炎患者进行了研究，通过结肠镜检查（n = 75）或手术切除（n = 22）确定宏观病变的范围。其中，42例患有直肠乙状结肠炎，12例患有左侧结肠炎，12例患有次全结肠炎，31例患有全结肠炎。使用9个经过充分验证的特征对病变范围进行放射学分类。未向放射科医生提供任何临床信息。腹部平片对78例患者（80.4%）进行了正确分类（r = 0.86）；直肠乙状结肠炎和全结肠炎的一致性最佳（分别为80.9%和90.3%）。在全结肠炎中，最可靠的放射学特征是“黏膜边缘不规则”和“结肠壁增厚”，分别在正确分类患者中的74.2%和67.7%中出现。这两个特征与“结肠袋消失”和“右半结肠空虚”的四重组合仅见于全结肠炎患者，除1例患者外，所有患者至少有其中1个特征。相反，在73.8%的直肠乙状结肠炎患者中，所有9种异常均不存在。总之，腹部平片是判断活动期溃疡性结肠炎病变范围的可靠工具。在全结肠炎中似乎特别准确，在急性期，避免进行侵入性检查最为重要。
