Department of Obstetrics and Gynecology, Division of Fetal and Maternal Medicine, Necmettin Erbakan University Medical School of Meram, Konya, Turkey.
J Clin Ultrasound. 2023 Oct;51(8):1335-1341. doi: 10.1002/jcu.23537. Epub 2023 Aug 17.
The aim of this study was to evaluate the efficacy and clinical effects of superior mesenteric artery (SMA) Doppler indices such as the systole diastole ratio (S/D), Pulsatility (PI), and resistance index (RI) in the diagnosis of hyperechogenic bowel.
A total of 133 pregnant women, including 66 with hyperechogenic bowel and 67 controls, were enrolled in the study. All participants were evaluated in the second trimester by an experienced obstetrician. Doppler measurements were performed, including superior mesenteric artery peak systolic velocity, S/D ratio, PI, and RI. Statistical analysis was conducted to compare the Doppler parameters between the hyperechogenic bowel and control groups.
No significant differences were found between the hyperechogenic bowel and control groups in terms of age, body mass index, gestational week, and fetal measurements. While SMA peak systolic velocity (PSV) showed no significant difference between the groups (p = 0.074), the S/D ratio (4.01 ± 0.59 vs. 3.27 ± 0.57, p = 0.0001), PI (1.51 ± 0.15 vs. 1.29 ± 0.06, p = 0.0001), RI (0.76 ± 0.05 vs. 0.67 ± 0.04, p = 0.0001) were significantly higher in the hyperechogenic bowel group compared to the control group. Screening tests based on Doppler parameters also demonstrated significant differences. The S/D ratio, PI, and RI exhibited good to excellent diagnostic accuracy, as indicated by the area under the curve values. Pregnant women with a high RI value of 0.72 were 101 times more likely to be diagnosed with HB. The odds ratio (OR) for diagnosing HB is 101.66 (CI 95%, 31.04-332.97).
Doppler indices, specifically the S/D ratio, PI, and RI, showed strong predictive ability and diagnostic accuracy in identifying cases of hyperechogenic bowel. These findings suggest that Doppler ultrasound can serve as a valuable tool for evaluating hyperechogenic bowel and may provide important clinical implications. Further diagnostic tests are warranted to determine the underlying cause of hyperechogenic bowel in individual cases.
本研究旨在评估肠系膜上动脉（SMA）多普勒指数（如收缩期/舒张期比值[S/D]、搏动指数[PI]和阻力指数[RI]）在诊断强回声肠中的疗效和临床效果。
共纳入 133 名孕妇，其中 66 例为强回声肠，67 例为对照组。所有参与者均由经验丰富的产科医生在孕中期进行评估。多普勒测量包括肠系膜上动脉峰值收缩速度、S/D 比值、PI 和 RI。对强回声肠组和对照组的多普勒参数进行统计学分析。
强回声肠组和对照组在年龄、体重指数、孕周和胎儿测量方面无显著差异。SMA 峰值收缩速度（PSV）在两组间无显著差异（p=0.074），但 S/D 比值（4.01±0.59 比 3.27±0.57，p=0.0001）、PI（1.51±0.15 比 1.29±0.06，p=0.0001）、RI（0.76±0.05 比 0.67±0.04，p=0.0001）明显更高。基于多普勒参数的筛查试验也显示出显著差异。S/D 比值、PI 和 RI 的曲线下面积值表明其具有良好到极好的诊断准确性。RI 值较高（0.72）的孕妇患 HB 的可能性高 101 倍。诊断 HB 的比值比（OR）为 101.66（95%CI，31.04-332.97）。
SMA 多普勒指数（S/D 比值、PI 和 RI）对强回声肠具有较强的预测能力和诊断准确性。这些发现表明，多普勒超声可以作为评估强回声肠的一种有价值的工具，并可能提供重要的临床意义。有必要进行进一步的诊断测试以确定个别病例中强回声肠的潜在原因。
