Sasaki Tomohiko, Kunisaki Reiko, Kinoshita Hiroto, Yamamoto Hisae, Kimura Hideaki, Hanzawa Akiho, Shibata Naomi, Yonezawa Hiromi, Miyajima Eiji, Sakamaki Kentaro, Numata Kazushi, Tanaka Katsuaki, Maeda Shin
Gastroenterological Center, Yokohama City University Medical Center , Yokohama , Japan.
Scand J Gastroenterol. 2014 Mar;49(3):295-301. doi: 10.3109/00365521.2013.871744. Epub 2013 Dec 18.
OBJECTIVE. Ultrasonography (US) is a simple, inexpensive and minimally invasive method. We evaluated the vascularity of small intestinal lesions in Crohn's disease using color Doppler US (CD-US) and retrospectively compared them with endoscopic and surgical macroscopic findings. MATERIAL AND METHODS. In order to compare CD-US and endoscopic findings, 108 Crohn's disease patients who underwent examination of the terminal ileum by both colonoscopy and CD-US were included in the study. Vascularity was evaluated in CD-US using a semiquantitative method, the Limberg score. We analyzed correlations between Limberg score and simple endoscopic score for Crohn's disease (SES-CD), an index reflecting endoscopic activity. Scores of SES-CD 3 and higher were defined as endoscopically active. For comparison with surgical macroscopic findings, 22 Crohn's disease patients who received CD-US and subsequent iliectomies were included. Lesions with apparent open ulcers were defined as active, and those without as non-active. These findings were compared with the Limberg score. RESULTS. A substantial positive correlation was observed between Limberg scores and SES-CD (ρ = 0.709 [p < 0.001]). Notably, all 27 cases with a Limberg score of 3 or 4 were classified as endoscopically active. Compared to surgical macroscopic activity, Limberg scores of active lesions were significantly higher than those of non-active lesions (p = 0.005). In particular, all 11 cases with a Limberg score of 3 or 4 were classified as active lesions. CONCLUSION. Vascularity of small intestinal lesions of Crohn's disease evaluated by CD-US with Limberg score is well correlated with endoscopic and surgical macroscopic findings.
目的。超声检查（US）是一种简单、廉价且微创的方法。我们使用彩色多普勒超声（CD-US）评估克罗恩病中小肠病变的血管情况，并回顾性地将其与内镜及手术宏观检查结果进行比较。材料与方法。为比较CD-US与内镜检查结果，本研究纳入了108例接受结肠镜检查及CD-US检查回肠末端的克罗恩病患者。采用半定量方法即林贝格评分评估CD-US中的血管情况。我们分析了林贝格评分与反映内镜活动度的克罗恩病简易内镜评分（SES-CD）之间的相关性。SES-CD评分3及以上被定义为内镜活动期。为与手术宏观检查结果进行比较，纳入了22例接受CD-US检查并随后进行回肠切除术的克罗恩病患者。有明显开放性溃疡的病变被定义为活动期，无开放性溃疡的病变被定义为非活动期。将这些结果与林贝格评分进行比较。结果。林贝格评分与SES-CD之间存在显著正相关（ρ = 0.709 [p < 0.001]）。值得注意的是，所有林贝格评分为3或4的27例病例均被分类为内镜活动期。与手术宏观活动度相比，活动期病变的林贝格评分显著高于非活动期病变（p = 0.005）。特别是，所有林贝格评分为3或4的11例病例均被分类为活动期病变。结论。用林贝格评分的CD-US评估的克罗恩病小肠病变血管情况与内镜及手术宏观检查结果具有良好的相关性。
