Wang Shuo, Li Shihui, Chen Shuling, Li Manying, Xie Xiaoyan, Ren Mao, Chen Yujun
Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2nd, Guangzhou 510080, China.
Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2nd, Guangzhou 510080, China.
Eur J Radiol Open. 2025 Jan 25;14:100632. doi: 10.1016/j.ejro.2024.100632. eCollection 2025 Jun.
To investigate the feasibility of real-time shear wave elastography (SWE) in evaluating intestinal wall stiffness, and to establish the threshold SWE value of normal intestinal wall and explore the influencing factors of intestinal SWE.
659 subjects who underwent intestinal SWE and colonoscopy were retrospectively enrolled. The wall elasticity of colonoscopy-confirmed normal/abnormal intestinal segment was measured by transabdominal SWE. Measurement reliability was evaluated by the intraclass correlation coefficient (ICC). The threshold value of SWE in differentiating normal and abnormal intestine was determined using ROC curve analysis with the largest Youden index, and the diagnostic performance of this threshold was evaluated. We explored the effects of gender, age, depth and type of the targeted intestinal segment on the intestinal wall elasticity by test and logistic linear regression analysis.
The technical success rate of SWE examination is 95.3 % (628/659). The mean SWE value of normal intestinal walls is (5.45 ± 1.34) kPa, which was significantly lower than that of abnormal ones (15.38 kPa±7.22, < 0.001). Using 8.1 kPa as the threshold， the sensitivity and specificity were 93.5 % and 96.0 % with an AUC of 94.8 %. The overall ICC for SWE measurements was 0.933. Gender (ß=0.278, = 0.013), depth (ß=0.220, = 0.043) and type of the targeted segment (ß=0.522, < 0.001) was associated with the SWE value of intestinal wall, but age was not (ß=0.050, = 0.484).
SWE is feasible in evaluating the stiffness of intestinal wall with high reliability. The SWE threshold value differentiating normal intestinal wall and abnormal intestinal wall is 8.1 kPa.
探讨实时剪切波弹性成像（SWE）评估肠壁硬度的可行性，确定正常肠壁的SWE阈值，并探讨肠道SWE的影响因素。
回顾性纳入659例行肠道SWE及结肠镜检查的受试者。经腹SWE测量结肠镜证实的正常/异常肠段的壁弹性。测量可靠性通过组内相关系数（ICC）进行评估。采用最大约登指数的ROC曲线分析确定区分正常和异常肠段的SWE阈值，并评估该阈值的诊断性能。通过t检验和逻辑线性回归分析探讨性别、年龄、目标肠段深度和类型对肠壁弹性的影响。
SWE检查的技术成功率为95.3%（628/659）。正常肠壁的平均SWE值为（5.45±1.34）kPa，显著低于异常肠壁（15.38 kPa±7.22，P<0.001）。以8.1 kPa为阈值，敏感性和特异性分别为93.5%和96.0%，AUC为94.8%。SWE测量的总体ICC为0.933。性别（β=0.278，P=0.013）、深度（β=0.220，P=0.043）和目标肠段类型（β=0.522，P<0.001）与肠壁SWE值相关，但年龄无关（β=0.050，P=0.484）。
SWE评估肠壁硬度具有可行性且可靠性高。区分正常肠壁和异常肠壁的SWE阈值为8.1 kPa。
