Department of Radiology, University of Calgary, Calgary, AB, Canada T2N 2T9; Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, AB, Canada T2N 2T9; Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, 8600 Silkeborg, Denmark; Department of Hepatology and Gastroenterology, Aarhus University Hospital, 8000 Aarhus C, Denmark.
Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, AB, Canada T2N 2T9.
Can J Gastroenterol Hepatol. 2016;2016:8745972. doi: 10.1155/2016/8745972. Epub 2016 Apr 19.
Background and Aims. We aim to evaluate the benefit of ultrasound in the assessment of Crohn's disease and to demonstrate its potential contribution to disease management. Methods. We conduct a retrospective review of adult patients with Crohn's disease examined with sonography and colonoscopy within 30 days. Study patients were identified in whom colonoscopy did not access a pathological segment, detected and evaluated by ultrasonography. Changes in management were predominantly attributed to ultrasound in those cases where the diseased segment was not assessed on endoscopy. Results. From 115 patients with temporally related ileocolonoscopy and ultrasound, 41 had disease fully assessed on ultrasound only, with complications in 26/41. Twenty-nine of 41 had mild or no endoscopic inflammation with moderate or severe disease on ultrasound at the same segment or at a segment proximal to the reach of the endoscope. Changes in management were significantly attributed to ultrasound in 22 of these 29 patients. Conclusion. The benefit of cross-sectional imaging is invaluable for the comprehensive assessment of bowel not shown on ileocolonoscopy. Ultrasound may make a significant contribution to correct classification of disease extent and severity of Crohn's disease. Prospective studies are needed to further understand the contribution of US in patient management.
背景和目的。我们旨在评估超声在克罗恩病评估中的益处，并展示其对疾病管理的潜在贡献。方法。我们对在 30 天内接受超声和结肠镜检查的成年克罗恩病患者进行回顾性研究。研究患者是通过超声检测和评估而结肠镜无法检查到的病变部位。如果内镜未评估病变部位，则主要归因于超声改变治疗方案。结果。在 115 例具有时间相关性回结肠镜和超声检查的患者中，41 例仅通过超声完全评估了疾病，其中 26/41 例出现并发症。在超声检查的同一部位或内镜检查可达范围近端的部位，41 例中有 29 例存在轻度或无内镜炎症，但超声检查显示中重度疾病。在这些 29 例患者中的 22 例中，超声显著改变了治疗方案。结论。对于未在回结肠镜下显示的肠道的全面评估，横截面成像的益处是非常宝贵的。超声可能对正确分类克罗恩病的疾病范围和严重程度做出重要贡献。需要前瞻性研究来进一步了解超声在患者管理中的作用。
