超声联合评分与简化内镜评分在克罗恩病活动度评估中的相关性研究。
Correlation between ultrasound consolidated score and simple endoscopic score for determining the activity of Crohn's disease.
机构信息
Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
Ultrasound Research and Education Institute, Tongji University Cancer Center, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, 200072, China.
出版信息
Br J Radiol. 2020 May 1;93(1109):20190614. doi: 10.1259/bjr.20190614. Epub 2020 Feb 28.
OBJECTIVES
The aim of this study was to develop an ultrasound consolidated score (UCS) in determining the activity of Crohn's disease (CD) and evaluate it with reference to simple endoscopic score (SES).
METHODS
From June 2014 to June 2017, 66 patients with CD were retrospectively enrolled in this study. Each patient underwent endoscopy and transabdominal ultrasound (US) examination. The morphological symmetry, echogenicity of bowel wall, bowel wall layer structure, echogenicity of peri-bowel fat, bowel wall thickness (BWT), and Limberg type on power Doppler US were assessed with transabdominal US, and an UCS scoring system was developed based on these characteristics. Endoscopic results were used as the reference standard and SES was calculated to determine the CD activity. Receiver operating characteristic curve analysis was performed to assess the diagnostic performance for determining CD activity and the correlation between UCS and SES was assessed using Spearman correlation analysis.
RESULTS
330 intestinal segments in 66 patients were included. The UCS of the segments in the remission phase ranged from 3.0 to 9.0 (mean, 3.6 ± 0.9) whereas in the active phase from 3.0 to 20.0 (mean, 10.6 ± 4.0) (p < 0.001). The cut-off value of UCS was 6. The associated area under ROC curve, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 0.980, 88.3%, 95.5%, 93.8%, 91.3%, and 92.3%, respectively. The correlation coefficient between UCS and SES was 0.90, which was higher than the correlation coefficient of 0.83 between BWT and SES.
CONCLUSIONS
The newly developed UCS with transabdominal US has a good performance and potentially provides an effective alternative for evaluating the activity of CD.
ADVANCES IN KNOWLEDGE
UCS is an effective method to evaluate the activity of CD because it provides comprehensive information of the disease. Therefore, it could be employed as an alternative for diagnosis of CD.
目的
本研究旨在制定一种超声综合评分（UCS），用于确定克罗恩病（CD）的活动度，并参照简单内镜评分（SES）进行评估。
方法
回顾性纳入 2014 年 6 月至 2017 年 6 月间的 66 例 CD 患者。每位患者均接受内镜和经腹超声（US）检查。采用经腹 US 评估肠壁形态对称性、肠壁回声、肠壁层次结构、肠壁周围脂肪回声、肠壁厚度（BWT）和动力多普勒超声的 Limberg 类型，并基于这些特征制定 UCS 评分系统。以内镜结果为参考标准，计算 SES 以确定 CD 活动度。采用受试者工作特征曲线分析评估用于确定 CD 活动度的诊断性能，并采用 Spearman 相关分析评估 UCS 与 SES 之间的相关性。
结果
纳入 66 例患者的 330 个肠段。缓解期肠段的 UCS 范围为 3.0 至 9.0（平均 3.6±0.9），活动期为 3.0 至 20.0（平均 10.6±4.0）（p<0.001）。UCS 的截断值为 6。ROC 曲线下面积、敏感度、特异度、阳性预测值、阴性预测值和准确度分别为 0.980、88.3%、95.5%、93.8%、91.3%和 92.3%。UCS 与 SES 的相关系数为 0.90，高于 BWT 与 SES 的相关系数 0.83。
结论
新制定的 UCS 结合经腹 US 具有良好的性能，可能为评估 CD 活动度提供有效的替代方法。
知识进展
UCS 是一种评估 CD 活动度的有效方法，因为它提供了疾病的综合信息。因此，它可以作为 CD 诊断的替代方法。
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