Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
Intern Med. 2022 Sep 15;61(18):2703-2709. doi: 10.2169/internalmedicine.8827-21. Epub 2022 Feb 19.
Objective Transabdominal ultrasonography (TUS) is a non-invasive procedure that is reportedly useful for managing ulcerative colitis (UC) and assessing bowel wall thickness (BWT), the most common measure of mucosal inflammation. However, the exact range of BWT that reflects disease activity remains undetermined. The present study clarified the BWT due to disease activity by comparing the use of TUS in each segment of the colon versus using colonoscopy (CS) and determined the usefulness of TUS in patients with UC. Methods We divided the colon into five segments and measured the BWT using TUS. The results were then compared to the Mayo endoscopic subscore (MES) classification to determine the accuracy of BWT measurement. Patients Eighty patients with UC who underwent TUS within 14 days of CS were retrospectively registered. Results We evaluated a total of 268 images depicting each segment among 80 patients with UC. The BWT was positively correlated with endoscopic activity (0.69, p<0.0001). In each segment, the relationship between a BWT>2 mm and an MES>0 had the highest sensitivity, specificity, and accuracy (0.85-1.00, 0.67-0.92, and 0.81-0.97, respectively). Conclusion This study concluded that TUS was a useful method of detecting an MES>0, which indicates the presence of inflammation and its location among UC patients. MES>0 was found to be highly accurate when a BWT>2 mm was considered positive. This non-invasive method may help control disease activity in patients with UC.
目的 经腹超声(TUS)是一种非侵入性程序,据报道可用于溃疡性结肠炎(UC)的治疗和评估肠壁厚度(BWT),BWT 是评估黏膜炎症最常用的指标。然而,反映疾病活动的 BWT 确切范围仍未确定。本研究通过比较 TUS 在结肠各段的应用与结肠镜检查(CS),明确了因疾病活动导致的 BWT,并确定了 TUS 在 UC 患者中的应用价值。 方法 将结肠分为五段,并使用 TUS 测量 BWT。然后将结果与 Mayo 内镜下评分(MES)分类进行比较,以确定 BWT 测量的准确性。 患者 回顾性登记了 80 例在 CS 后 14 天内接受 TUS 的 UC 患者。 结果 我们评估了 80 例 UC 患者的 268 张图像,这些图像分别显示了每个肠段。BWT 与内镜活动呈正相关(0.69,p<0.0001)。在每个肠段中,BWT>2mm 与 MES>0 之间的关系具有最高的敏感性、特异性和准确性(0.85-1.00、0.67-0.92 和 0.81-0.97)。 结论 本研究表明,TUS 是一种检测 MES>0 的有用方法,它可以提示 UC 患者存在炎症及其部位。当 BWT>2mm 时,MES>0 的准确性很高。这种非侵入性方法可能有助于控制 UC 患者的疾病活动。