Elli Luca, Centorrino Erica, Costantino Andrea, Vecchi Maurizio, Orlando Stefania, Fraquelli Mirella
Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Clin Endosc. 2022 Jul;55(4):532-539. doi: 10.5946/ce.2021.224. Epub 2022 Jul 28.
BACKGROUND/AIMS: Capsule enteroscopy (CE) and intestinal ultrasonography (IUS) are techniques that are currently used for investigating small-bowel (SB) diseases. The aim of this study was to compare the main imaging findings and the lesion detection rate (LDR) of CE and IUS in different clinical scenarios involving the SB.
We retrospectively enrolled patients who underwent CE and IUS for obscure gastrointestinal bleeding (OGIB), complicated celiac disease (CeD), and suspected or known inflammatory bowel disease (IBD). We evaluated the LDR of both techniques. The accuracy of IUS was determined using CE as the reference standard.
A total of 159 patients (113 female; mean age, 49±19 years) were enrolled. The LDR was 55% and 33% for CE and IUS (p<0.05), respectively. Subgroup analysis showed that the LDR of CE was significantly higher than that of IUS in patients with OGIB (62% vs. 14%, p<0.05) and CeD (55% vs. 35%, p<0.05). IUS showed a similar LDR to CE in patients with suspected or known IBD (51% vs. 46%, p=0.83).
CE should be preferred in cases of OGIB and CeD, whereas IUS should be considered an early step in the diagnosis and follow-up of IBD even in patients with a proximal SB localization of the disease.
背景/目的：胶囊内镜（CE）和肠道超声检查（IUS）是目前用于研究小肠（SB）疾病的技术。本研究的目的是比较CE和IUS在涉及SB的不同临床情况下的主要影像学表现和病变检出率（LDR）。
我们回顾性纳入了因不明原因胃肠道出血（OGIB）、复杂性乳糜泻（CeD）以及疑似或已知炎症性肠病（IBD）而接受CE和IUS检查的患者。我们评估了这两种技术的LDR。以CE作为参考标准来确定IUS的准确性。
共纳入159例患者（女性113例；平均年龄49±19岁）。CE和IUS的LDR分别为55%和33%（p<0.05）。亚组分析显示，在OGIB患者中，CE的LDR显著高于IUS（62%对14%，p<0.05），在CeD患者中也是如此（55%对35%，p<0.05）。在疑似或已知IBD的患者中IUS的LDR与CE相似（51%对46%，p=0.83）。
在OGIB和CeD病例中应首选CE，而即使在疾病位于近端小肠的IBD患者中，IUS也应被视为IBD诊断和随访的早期步骤。
