Limberg B, Osswald B
Medizinische Klinik, Städtisches Krankenhaus Wolfenbüttel-Braunschweig.
Dtsch Med Wochenschr. 1993 Aug 20;118(33):1181-7. doi: 10.1055/s-2008-1059441.
As part of a prospective study the value of hydrocolonic sonography in the diagnosis and differential diagnosis of Crohn's disease (CD) and ulcerative colitis (UC) was assessed and compared with that of coloscopy as standard reference. Of 440 patients who were examined, 41 (23 men, 18 women; mean age 25 +/- 6 years) had CD and 36 (20 men, 16 women; mean age 32 +/- 8 years) had UC. CD and UC were correctly diagnosed by hydrocolonic sonography in 39 and 33 cases, respectively (sensitivity 95 and 91%, specificity 100 and 99%, respectively). Among healthy subjects five layers of variable echo density were demonstrated in the intestinal wall, while in all those with CD the wall was clearly thickened and in 36 of them the wall structure was also abnormal. In 16 patients the wall structure was homogeneous without evidence of layers and in 20, layers 1-3 were not demonstrable and layers 4 and 5 only rudimentary. In contrast, the 33 patients with UC diagnosed by hydrocolonic sonography had only slight thickening of the intestinal wall and all layers were present in 30 of them. CD and UC were correctly distinguished in 91%. Hydrocolonic sonography makes it possible to demonstrate in detail the structural changes in the intestinal wall in CD and UC so that the two conditions can be distinguished.
作为一项前瞻性研究的一部分，评估了水灌肠超声检查在克罗恩病（CD）和溃疡性结肠炎（UC）诊断及鉴别诊断中的价值，并与作为标准参照的结肠镜检查进行比较。在接受检查的440例患者中，41例（23例男性，18例女性；平均年龄25±6岁）患有CD，36例（20例男性，16例女性；平均年龄32±8岁）患有UC。水灌肠超声检查分别在39例和33例中正确诊断出CD和UC（敏感性分别为95%和91%，特异性分别为100%和99%）。在健康受试者中，肠壁显示出五层回声密度可变的结构，而在所有CD患者中，肠壁明显增厚，其中36例肠壁结构也异常。16例患者肠壁结构均匀，无分层迹象，20例患者中，1 - 3层不可见，4层和5层仅呈雏形。相比之下，经水灌肠超声检查诊断为UC的33例患者肠壁仅轻度增厚，其中30例各层均存在。CD和UC的正确鉴别率为91%。水灌肠超声检查能够详细显示CD和UC患者肠壁的结构变化，从而区分这两种疾病。
