Post-Graduation Program in Surgical Sciences, Department of Surgery, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Int J Colorectal Dis. 2013 Dec;28(12):1613-20. doi: 10.1007/s00384-013-1755-0. Epub 2013 Aug 8.
Endoscopic ultrasound (EUS) imaging of the colon is an important diagnostic tool for early neoplasia, although usually restricted to the rectum in inflammatory bowel disease (IBD). This study aimed to evaluate the ability of an endoluminal ultrasound biomicroscopic (eUBM) system to detect and characterize lesions simulating Crohn's disease in the colon of rats in vivo.
Colitis was induced with trinitrobenzene sulfonic acid instillated in the distal colon. Eighteen Wistar rats were submitted to eUBM in three time points: week 1 group (18 animals examined on day 3 after colitis induction), week 2 group (12 animals on days 3 and 10), and week 3 group (7 animals on days 3, 10, and 17). This design yielded distinct inflammation intensities. Three untreated rats were used for acquisition of control images. Scores were used for comparison with histology.
Scores for eUBM and histology in the different moments of examination achieved a Spearman's rank correlation coefficient of 0.87 (p < 0.001). Findings of wall thickening presented positive predictive value (PPV) and sensitivity of 94 and of 100 %, respectively. Superficial and deep ulcers presented a PPV of 89 and 80 %, respectively, and negative predictive values of 100 and 85 %, respectively.
Accurate detection and analysis of the lesions was achieved. The model is essential for the clinical development of the technique and a reproducible method for the evaluation of experimental colitis. eUBM might be applicable in different segments of the gut, developing into a novel adjunct method for IBD evaluation.
内镜超声(EUS)成像技术是诊断早期肿瘤的重要手段,尽管在炎症性肠病(IBD)中通常仅限于直肠。本研究旨在评估腔内超声生物显微镜(eUBM)系统检测和识别模拟克罗恩病的病变的能力,以及在体内评估大鼠结肠病变的能力。
通过在远端结肠中灌注三硝基苯磺酸诱导结肠炎。18 只 Wistar 大鼠分为 3 组,每组 6 只,在 3 个时间点接受 eUBM 检查:第 1 周组(18 只动物,在结肠炎诱导后第 3 天检查)、第 2 周组(12 只动物,在第 3 天和第 10 天检查)和第 3 周组(7 只动物,在第 3 天、第 10 天和第 17 天检查)。这种设计产生了不同的炎症强度。3 只未处理的大鼠用于采集对照图像。评分用于与组织学比较。
不同检查时间点的 eUBM 和组织学评分之间的 Spearman 等级相关系数为 0.87(p < 0.001)。壁增厚的检出具有 94%的阳性预测值(PPV)和 100%的敏感性。浅表和深部溃疡的 PPV 分别为 89%和 80%,阴性预测值分别为 100%和 85%。
实现了对病变的准确检测和分析。该模型对于该技术的临床开发和实验性结肠炎的可重复性评估至关重要。eUBM 可能适用于肠道的不同部位,发展成为 IBD 评估的一种新的辅助方法。