Sugiura Kaori, Kato Shingo, Ishibashi Akira, Aoyama Toru, Kani Kazuhito, Yakabi Koji
Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University.
Nihon Shokakibyo Gakkai Zasshi. 2020;117(8):695-705. doi: 10.11405/nisshoshi.117.695.
Transabdominal ultrasound is a promising technique to evaluate inflammatory bowel disease. Several studies have demonstrated a relationship between ultrasound findings and colonic inflammation. However, the applicability of transabdominal ultrasound in patients with ulcerative colitis (UC) has not been elucidated. The aim of this study was to clarify the relationship between the transabdominal ultrasound findings and endoscopic activity in patients with UC.
Patients with active and underwent transabdominal ultrasound and colonoscopy were enrolled in this retrospective single-center analysis. Blood flow in the bowel wall was evaluated by power Doppler ultrasound. Both the thickness and stratification of the bowel wall were assessed by B-mode ultrasound imaging. The endpoints were the correlations between the ultrasound appearances (i.e., blood flow, thickness, and stratification of the bowel wall) and endoscopic activity (endoscopic Mayo Score).
There were 34 lesions in 26 patients evaluated. Blood flow and thickness of the bowel wall were positively significantly correlated with the endoscopic Mayo Scores (r=0.43, p=0.011 and r=0.503, p=0.002, respectively). According to the bowel stratification, the endoscopic Mayo Scores were significantly higher in unclear and diminished bowel wall stratifications than in the clear bowel wall stratifications (p<0.001 and p<0.001, respectively). When focusing on the endoscopic Mayo Scores of three lesions, blood flow was lower in ulcer lesions with a diameter of ≥10mm than in those with a diameter of <10mm.
All transabdominal ultrasound findings of bowel blood flow, wall thickness, and wall stratification reflected colonic inflammation.
经腹超声是评估炎症性肠病的一种有前景的技术。多项研究已证实超声检查结果与结肠炎症之间存在关联。然而，经腹超声在溃疡性结肠炎（UC）患者中的适用性尚未阐明。本研究的目的是明确UC患者经腹超声检查结果与内镜下活动度之间的关系。
本回顾性单中心分析纳入了接受经腹超声和结肠镜检查的活动期患者。通过功率多普勒超声评估肠壁血流。通过B型超声成像评估肠壁厚度和分层。终点指标是超声表现（即肠壁血流、厚度和分层）与内镜下活动度（内镜梅奥评分）之间的相关性。
共评估了26例患者的34个病变。肠壁血流和厚度与内镜梅奥评分呈显著正相关（r分别为0.43，p = 0.011和r = 0.503，p = 0.002）。根据肠壁分层情况，肠壁分层不清晰和减弱的患者内镜梅奥评分显著高于肠壁分层清晰的患者（p均<0.001）。聚焦于三个病变的内镜梅奥评分时，直径≥10mm的溃疡病变的血流低于直径<10mm的溃疡病变。
肠血流、肠壁厚度和肠壁分层的所有经腹超声检查结果均反映结肠炎症。
