B 型和弹性超声技术在预测幽门螺杆菌中的疗效：一项前瞻性研究。

Efficacy of B - mode and elastography ultrasound technique in the prediction of Helicobacter pylori: a prospective study.

机构信息

Graduate College, University of Medical Science and Technology (UMST), Khartoum, Sudan.

Ultrasound Unit and Laboratory Department, Dr. Ahmed Alzomor Specialized Poly Clinic, Ibb, 04-427015, Yemen.

出版信息

BMC Gastroenterol. 2024 Nov 28;24(1):440. doi: 10.1186/s12876-024-03529-9.

DOI:10.1186/s12876-024-03529-9

PMID:39609753

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11603853/

Abstract

BACKGROUND

Helicobacter pylori (HP) affect nearly 50% of the world's population and can colonize the submucosal and mucosal layers of the stomach wall, causing inflammation leading to a thickening of these layers. The study aimed to evaluate the application value of transabdominal ultrasonography combined with elastography in the prediction of HP using HP Fecal Antigen Test as gold standard.

METHOD

This prospective case-control study was conducted in 174 participants classified into three groups: Group A: Symptomatic patients with thickened stomach antral and evident HP infection on fecal antigen test results, Group B: Symptomatic patients with thickened antral and no evident HP infection on fecal antigen test results, and Group C: control group of asymptomatic individuals with negative HP screening to predict the diagnostic accuracy of B-mode ultrasound and elastography in the prediction of HP pylori.

RESULTS

Positive HP patients had higher values of antral wall thickness (AWT), mucosal layer thickness (MLT), MLT/AWT ratio, SR (strain ratio), and a combination of AWT and SR: 5.57 ± 0.55 mm, 2.96 ± 0.45 mm, 0.53 ± 0.06 mm, 3.21 ± 0.43, and 8.79 ± 0.68 mm, respectively. In comparison, negative HP patients had values of 4.61 ± 0.47 mm, 2.05 ± 0.42 mm, 0.41 ± 0.08 mm, 2.51 ± 0.42 mm, and 7.13 ± 0.62 mm, respectively, and the control groups had values of 3.53 ± 0.36 mm, 1.47 ± 0.25 mm, 0.40 ± 0.06 mm, 1.81 ± 0.41, and 5.35 ± 0.55 mm, respectively (p < 0.001). The sensitivity of B-mode ultrasonography, elastography, and the combination of the two was 98%, 95.1%, and 98.4%, respectively, and the diagnostic accuracy was 98.4%, 98.3%, and 100%, respectively.

CONCLUSION

B-mode ultrasonography and elastography exhibit high discriminatory power in distinguishing symptomatic HP patients from normal individuals and differentiating + HP from - HP, with greater discriminatory power when combined both modes.

摘要

背景

幽门螺杆菌（HP）影响全球近 50%的人口，可定植于胃壁的黏膜下层和黏膜层，导致炎症，使这些层变厚。本研究旨在评估经腹超声联合弹性成像在 HP 粪便抗原检测作为金标准的情况下对 HP 的预测应用价值。

方法

这是一项前瞻性病例对照研究，共纳入 174 名参与者，分为三组：A 组：有症状的患者，胃窦壁增厚，粪便抗原检测结果显示明显的 HP 感染；B 组：有症状的患者，胃窦壁增厚，粪便抗原检测结果无明显的 HP 感染；C 组：无症状个体的对照组，HP 筛查阴性，预测 B 型超声和弹性成像对预测 HP 幽门螺杆菌的诊断准确性。

结果

阳性 HP 患者的胃窦壁厚度（AWT）、黏膜层厚度（MLT）、MLT/AWT 比值、SR（应变比）和 AWT 与 SR 的组合值更高：分别为 5.57±0.55mm、2.96±0.45mm、0.53±0.06mm、3.21±0.43mm 和 8.79±0.68mm。相比之下，阴性 HP 患者的数值分别为 4.61±0.47mm、2.05±0.42mm、0.41±0.08mm、2.51±0.42mm 和 7.13±0.62mm，对照组的数值分别为 3.53±0.36mm、1.47±0.25mm、0.40±0.06mm、1.81±0.41mm 和 5.35±0.55mm（p<0.001）。B 型超声、弹性成像和两者联合的灵敏度分别为 98%、95.1%和 98.4%，诊断准确率分别为 98.4%、98.3%和 100%。