肠道超声评分在预测溃疡性结肠炎长期内镜结局中的价值。

The value of intestinal ultrasound scores in predicting long-term endoscopic outcomes in ulcerative colitis.

作者信息

Ma Li, Wang Zhaojue, Zhang Xiaoyan, Xiao Mengsu, Qin Jing, Zhou Mengyuan, Yang Hong, Zhu Qingli, Li Wenbo

机构信息

Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.

Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Therap Adv Gastroenterol. 2025 Sep 12;18:17562848251375374. doi: 10.1177/17562848251375374. eCollection 2025.

DOI:10.1177/17562848251375374

PMID:40949848

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12432316/

Abstract

BACKGROUND

The value of intestinal ultrasound (IUS) in predicting treatment outcomes in ulcerative colitis (UC) remains underexplored.

OBJECTIVES

To compare the predictive accuracy of representative IUS scores for long-term endoscopic outcomes in UC.

DESIGN

A retrospective observational study.

METHODS

Consecutive UC patients initiating biologics/small-molecule drugs were enrolled. IUS examinations were performed at baseline, 4-6 months, and at the first colonoscopy reassessment (12-30 months). IUS images were reviewed, and bowel wall thickness (BWT), Milan ultrasound criteria (MUC), and International Bowel Ultrasound Segmental Activity Score (IBUS-SAS) were recorded. Endoscopic response was assessed using the Mayo Endoscopic Score (MES), with remission defined as MES = 0 and improvement as MES ⩽1.

RESULTS

Forty-nine patients were included. All three IUS scores showed significant correlations with concurrent MES, with IBUS-SAS demonstrating the strongest association (BWT, ρ = 0.54; MUC, ρ = 0.55; IBUS-SAS, ρ = 0.69). IBUS-SAS at 4-6 months was the most accurate predictor of long-term endoscopic remission (area under the curve (AUC) 0.767) and endoscopic improvement (AUC 0.770). On multivariable analysis, an IBUS-SAS score <25.5 at 4-6 months was the only independent predictor of endoscopic remission (odds ratio (OR) 7.6, = 0.005), while an IBUS-SAS score <38.0 was the only independent predictor of endoscopic improvement (OR 5.8, = 0.006).

CONCLUSION

The IBUS-SAS score at early follow-up may serve as a valuable predictor of long-term endoscopic outcomes in UC.

摘要

背景

肠道超声（IUS）在预测溃疡性结肠炎（UC）治疗结局方面的价值仍未得到充分探索。

目的

比较代表性IUS评分对UC长期内镜结局的预测准确性。

设计

一项回顾性观察研究。

方法

纳入开始使用生物制剂/小分子药物的连续UC患者。在基线、4 - 6个月以及首次结肠镜复查时（12 - 30个月）进行IUS检查。回顾IUS图像，记录肠壁厚度（BWT）、米兰超声标准（MUC）和国际肠道超声节段活动评分（IBUS - SAS）。使用梅奥内镜评分（MES）评估内镜反应，缓解定义为MES = 0，改善定义为MES≤1。

结果

纳入49例患者。所有三个IUS评分均与同期MES显著相关，其中IBUS - SAS的相关性最强（BWT，ρ = 0.54；MUC，ρ = 0.55；IBUS - SAS，ρ = 0.69）。4 - 6个月时的IBUS - SAS是长期内镜缓解（曲线下面积（AUC）0.767）和内镜改善（AUC 0.770）的最准确预测指标。多变量分析显示，4 - 6个月时IBUS - SAS评分<25.5是内镜缓解的唯一独立预测指标（比值比（OR）7.6，P = 0.005），而IBUS - SAS评分<38.0是内镜改善的唯一独立预测指标（OR 5.8，P = 0.006）。