Yiğit Betül, Sezgin Orhan, Yorulmaz Elif, Ertürk Mehmet Şükrü, Erdem Umut, Yanç Uğur, Bilik Oyman Gamze, Yorulmaz Hatice
Department of Internal Medicine, University of Health Sciences, Bağcılar Training and Research Hospital, İstanbul, Turkey.
Faculty of Medicine, Department of Gastroenterology, Mersin University, İstanbul, Turkey.
Turk J Gastroenterol. 2022 Apr;33(4):294-303. doi: 10.5152/tjg.2022.201157.
Non-invasive methods play an important role in clinical assessment of Crohn's disease. Recent studies have highlighted the effectiveness and reliability of intestinal ultrasonography. We aimed to examine the relationship between intestinal ultrasonography and the clinical, endoscopic, and computed tomography enterography findings, and to assess the activity of Crohn's disease.
This was a 1-year prospective study involving patients diagnosed with Crohn's Disease. Clinical and endoscopic activity indi- ces, and intestinal ultrasonography and computed tomography enterography findings were evaluated. Intestinal wall thickness, mes- enteric inflammation, lymphadenopathy, and complications were evaluated by intestinal ultrasonograpy and computed tomography enterography, while the superior mesenteric artery flow velocity, resistive index, and Limberg score were assessed by Doppler intestinal ultrasonography.
Seventy-nine patients with Crohn's disease were included. A significant correlation was found between intestinal wall thick- ness, mesenteric inflammation, and complications in intestinal ultrasonography and computed tomography enterography (P = .0001). According to the receiver operating curve analysis, the intestinal wall thickness, and mesenteric inflammation were correlated with the Crohn's Disease Activity Index, Harvey-Bradshaw Index, and SES-CD scores (P < .05), and they were very effective in distinguishing active from inactive disease. According to the Crohn's Disease Activity Index and SES-CD scores, Doppler flow velocity of the superior mesenteric artery was significantly higher in the active group than in the inactive group (P < .05). The Limberg score was very consistent with the Crohn's Disease Activity Index, Harvey-Bradshaw Index , and the results of the Simple Endoscopic Score for Crohn's Disease (P < .0001).
Our study showed that intestinal ultrasonography is an effective and reliable method for assessment of Crohn's disease activity compared to clinical, endoscopic, and CTE findings.
非侵入性方法在克罗恩病的临床评估中发挥着重要作用。近期研究突出了肠道超声检查的有效性和可靠性。我们旨在研究肠道超声检查与临床、内镜及计算机断层扫描小肠造影结果之间的关系，并评估克罗恩病的活动度。
这是一项为期1年的前瞻性研究，纳入了被诊断为克罗恩病的患者。对临床和内镜活动指标、肠道超声检查及计算机断层扫描小肠造影结果进行评估。通过肠道超声检查和计算机断层扫描小肠造影评估肠壁厚度、肠系膜炎症、淋巴结病变及并发症，同时通过多普勒肠道超声检查评估肠系膜上动脉血流速度、阻力指数和林贝格评分。
纳入了79例克罗恩病患者。发现肠道超声检查和计算机断层扫描小肠造影中的肠壁厚度、肠系膜炎症及并发症之间存在显著相关性（P = 0.0001）。根据受试者工作特征曲线分析，肠壁厚度和肠系膜炎症与克罗恩病活动指数、哈维 - 布拉德肖指数及SES - CD评分相关（P < 0.05），且在区分疾病活动期和非活动期方面非常有效。根据克罗恩病活动指数和SES - CD评分，活动组肠系膜上动脉的多普勒血流速度显著高于非活动组（P < 0.05）。林贝格评分与克罗恩病活动指数、哈维 - 布拉德肖指数以及克罗恩病简易内镜评分结果高度一致（P < 0.0001）。
我们的研究表明，与临床、内镜及CTE检查结果相比，肠道超声检查是评估克罗恩病活动度的一种有效且可靠的方法。
