Kellar Amelia, Chavannes Mallory, Huynh Hien Q, Aronskyy Illya, Lei Bryan, deBruyn Jennifer C, Kim Justin, Dolinger Michael T
Section of Pediatric Gastroenterology, Hepatology and Nutrition, Comer Children's Hospital at the University of Chicago, Chicago, Illinois, USA.
Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
J Pediatr Gastroenterol Nutr. 2025 Jul;81(1):53-61. doi: 10.1002/jpn3.70049. Epub 2025 Apr 29.
Intestinal ultrasound (IUS) is a noninvasive tool for detecting and monitoring disease activity in children with inflammatory bowel disease (IBD). Remission values for bowel wall thickness (BWT) are extrapolated from adult data. We aimed to define normal BWT in children with IBD in sustained deep remission.
Multicenter, retrospective pediatric IUS database including children with IBD, without a history of surgery or complications, who underwent IUS after achieving sustained deep remission, defined as the absence of ulcerations on ileocolonoscopy and/or transmural healing on magnetic resonance enterography and steroid-free clinical remission for ≥6 months. Univariate and multivariable analyses were performed using mixed-effect modeling.
Ninety-eight children (40 [41%] female; 64 [5%] Crohn's disease [CD]: 29 (30%) ulcerative colitis [UC]: 5 (5%) IBD-unspecified), median age 15.2 [13.8-16.8] years), and 484 bowel segments were included. Median BWT was 1.4 (1.1-1.6) mm, with no difference in BWT between bowel segments (p = 0.28). In multivariable analysis, a positive association remained between BWT and weight (univariate β = 0.004 [95% confidence interval, CI = 0.001-0.007], p = 0.016, multivariate β = 0.006 [95% CI = 0.001-0.011], p = 0.041). A negative association remained between BWT and disease duration (unadjusted β = -0.024 [95% CI = -0.047 to -0.001] p = 0.046, adjusted β = -0.028 [95% CI = -0.052 to -0.003], p = 0.039).
Previously inflamed BWT for children with IBD in sustained deep remission was less than 2.5 mm, which is less than 3 mm in adults, and unaffected by age, sex, and bowel segment in this population. BWT may be affected by weight and disease duration. These findings are crucial to the standardized assessment of transmural healing in children.
肠道超声（IUS）是一种用于检测和监测炎症性肠病（IBD）患儿疾病活动的非侵入性工具。肠壁厚度（BWT）的缓解值是根据成人数据推断出来的。我们旨在确定处于持续深度缓解期的IBD患儿的正常BWT。
多中心回顾性儿科IUS数据库，纳入了无手术或并发症史、在实现持续深度缓解后接受IUS检查的IBD患儿。持续深度缓解定义为回结肠镜检查无溃疡和/或磁共振肠造影显示透壁愈合，且无类固醇临床缓解≥6个月。使用混合效应模型进行单变量和多变量分析。
纳入了98名儿童（40名[41%]女性；64名[5%]克罗恩病[CD]：29名[30%]溃疡性结肠炎[UC]：5名[5%]未特定的IBD），中位年龄15.2[13.8 - 16.8]岁，以及484个肠段。中位BWT为1.4（1.1 - 1.6）mm，肠段之间的BWT无差异（p = 0.28）。在多变量分析中，BWT与体重之间仍存在正相关（单变量β = 0.004[95%置信区间，CI = 0.001 - 0.007]，p = 0.016，多变量β = 0.
