Division of Rheumatology, Department of Internal Medicine, School of Medicine, Marmara University, Fevzi Çakmak Mahallesi, Ust-Kaynarca, Pendik, Istanbul, Turkey.
Department of Radiology, School of Medicine, Marmara University, Fevzi Çakmak Mahallesi, Ust-Kaynarca, Pendik, Istanbul, Turkey.
Dig Dis Sci. 2021 Aug;66(8):2750-2755. doi: 10.1007/s10620-020-06587-7. Epub 2020 Sep 14.
Behçet's disease (BD) and Crohn's disease (CD) cannot be easily differentiated in young adults presenting with nonspecific gastrointestinal (GI) manifestations due to similar extraintestinal manifestations. We recently showed that increased common femoral vein (CFV) thickness is a distinctive feature of BD, rarely present in other inflammatory or vascular diseases with a specificity higher than 80% for the cutoff value of ≥ 0.5 mm. We suggest that CFV thickness measurement with ultrasonography (US) can be a diagnostic tool for BD.
To assess the diagnostic performance of CFV thickness measurement in the differential diagnosis of BD and CD.
Patients with BD (n = 69), CD (n = 38), and healthy controls (HC) (n = 38) were included in the study. Bilateral CFV thickness was measured with Doppler US.
Both right and left CFV thicknesses were significantly higher in BD compared to HC and CD (for right: 0.76 mm vs 0.33 mm, for left: 0.78 mm vs 0.35 mm, p < 0.001 for both). CFV thicknesses in CD were similar to HC (p > 0.05 for both). CFV thickness was also similar between BD patients with and without GI involvement (p = 0.367). The diagnostic cutoff values of ≥ 0.5 mm for CFV thickness performed well against to both CD and HCs for discrimination of BD. The sensitivity and specificity rates were > 85% for both HC and CD. Positive and negative predictive values in our tertiary clinical setting were > 90%.
We found significantly lower CFV thickness in CD compared to BD. Our results suggest that CFV wall thickness measurement is a distinctive diagnostic tool for the differentiation of BD and CD and can be helpful in daily practice for the differentiation of two diseases.
由于类似的肠外表现，在出现非特异性胃肠道（GI）表现的年轻成人中，贝赫切特病（BD）和克罗恩病（CD）很难区分。我们最近表明，股总静脉（CFV）厚度增加是 BD 的一个独特特征，在其他炎症性或血管性疾病中很少出现，其截断值≥0.5mm 的特异性高于 80%。我们建议超声（US）测量 CFV 厚度可作为 BD 的诊断工具。
评估 CFV 厚度测量在 BD 和 CD 鉴别诊断中的诊断性能。
本研究纳入了 69 例 BD 患者、38 例 CD 患者和 38 例健康对照者（HC）。使用多普勒 US 测量双侧 CFV 厚度。
与 HC 和 CD 相比，BD 患者的右 CFV 和左 CFV 厚度均显著更高（右侧：0.76mm 比 0.33mm，左侧：0.78mm 比 0.35mm，均 p<0.001）。CD 患者的 CFV 厚度与 HC 相似（均 p>0.05）。BD 患者中无论是否存在 GI 受累，CFV 厚度均相似（p=0.367）。CFV 厚度≥0.5mm 的截断值对 BD 与 CD 和 HC 的鉴别诊断效果良好。对 HC 和 CD，敏感性和特异性率均>85%。在我们的三级临床环境中，阳性和阴性预测值均>90%。
我们发现 CD 患者的 CFV 厚度明显低于 BD。我们的结果表明 CFV 壁厚度测量是鉴别 BD 和 CD 的独特诊断工具，在日常实践中有助于区分两种疾病。
