Department of Radiology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
Center for Crohn's and Colitis, Department of Gastroenterology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
J Ultrasound Med. 2023 Dec;42(12):2791-2802. doi: 10.1002/jum.16317. Epub 2023 Aug 14.
To analyze the correlation between intestinal ultrasound (IUS) and serum and fecal biomarkers, and the characteristics of small bowel disease, for the assessment of active bowel inflammation.
Patients with Crohn's disease (CD) who underwent an initial IUS examination between July 2018 and November 2022 at our institution were included retrospectively. We divided small and large bowels into seven segments, and recorded the presence of active inflammation according to following criteria: bowel wall thickness ≥ mm with ≥1 of feature of active disease on IUS. The correlations between IUS-assessed activity and serum C-reactive protein (CRP, mg/dL) and fecal calprotectin (FC, μg/g) levels were analyzed.
A total of 127 patients were included (mean age: 32.42 ± 12.07, M:F = 90:37, median disease duration 6 years [0-35]). Of them, 78 showed active bowel inflammation (61.4%), with inflammation distal to the terminal ileum being the most common disease location (n = 61, 78.2%). FC and serum CRP levels were significantly correlated with the number of segments with active inflammation (rho = 0.58, 0.48), number of segments with complications (r = 0.35, 0.31), and US activity score (r = 0.62, 0.54). With FC cutoff values of 100 and 150 μg/g, the concordance rates for patients with active small bowel disease were 78.7% (26/33) and 72.7% (24/33), respectively, which were better than those for other disease locations.
Disease activity determined by IUS was significantly correlated with the biomarkers, with a better concordance rate in patients with active small bowel disease than in those with other disease locations with FC cut-off values of 100 and 150 μg/g.
分析肠超声（IUS）与血清和粪便生物标志物之间的相关性，以及小肠疾病的特征，用于评估肠道活动性炎症。
回顾性纳入 2018 年 7 月至 2022 年 11 月在我院行初次 IUS 检查的克罗恩病（CD）患者。我们将小肠和大肠分为七个节段，根据以下标准记录活动性炎症的存在：肠壁厚度≥mm，IUS 上存在≥1 项活动性疾病特征。分析 IUS 评估的活动度与血清 C 反应蛋白（CRP，mg/dL）和粪便钙卫蛋白（FC，μg/g）水平之间的相关性。
共纳入 127 例患者（平均年龄 32.42±12.07 岁，M∶F=90∶37，中位疾病病程 6 年[0-35]）。其中 78 例患者存在肠道活动性炎症（61.4%），最常见的疾病部位为末端回肠远端（n=61，78.2%）。FC 和血清 CRP 水平与活动性炎症节段数（rho=0.58，0.48）、合并并发症节段数（r=0.35，0.31）和 US 活动评分（r=0.62，0.54）显著相关。FC 截断值分别为 100 和 150μg/g 时，对小肠疾病活动性的一致性率分别为 78.7%（26/33）和 72.7%（24/33），均优于其他疾病部位。
IUS 确定的疾病活动度与生物标志物显著相关，FC 截断值为 100 和 150μg/g 时，在有小肠疾病活动的患者中具有更好的一致性率。
