在评估儿科炎症性肠病活动性时使用彩色多普勒超声波评估肠壁流动情况

Q3 Medicine Radiologia Brasileira Pub Date : 2023-12-15 DOI:10.1590/0100-3984.2023.0039-en
Marco Aurélio Castellano, Vanessa Scheeffer, Vanessa Petersen, Themis Reverbel da Silveira
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引用次数: 0

摘要

摘要 目的用多普勒超声评估儿科炎症性肠病(IBD)的活动性,比较超声结果与粪便钙蛋白(FC)浓度的准确性。材料和方法:我们对 2014 年至 2020 年间接诊的 44 名儿科患者的 53 次检查进行了连续系列评估:其中 28 人患有克罗恩病,15 人患有溃疡性结肠炎,1 人患有未分类的 IBD。IBD的诊断是根据波尔图标准做出的。研究中最详细的改变是肠壁血流,由首席研究员和两名儿科放射科医生进行分类,他们对 FC 浓度和其他超声波检查结果都是盲法。如果多普勒超声波信号不超过 2 个/平方厘米,肠壁血流被归类为低度;如果信号为 3-5 个/平方厘米,则为中度;如果信号超过 5 个/平方厘米,则为高度。结果:放射科医生之间的意见非常一致(kappa = 0.73)。在超声波显示肠壁血流较低的病例中,FC 浓度的中位数为 92 微克/克(四分位间范围为 33-661 微克/克),而在超声波显示肠壁血流较高的病例中,FC 浓度的中位数为 2286 微克/克(四分位间范围为 1728-5612 微克/克)。在所有样本中,超声波检测炎症活动的敏感性和特异性分别为 89.7% 和 92.0%;检测克罗恩病的敏感性和特异性分别为 95.5% 和 90.9%;检测溃疡性结肠炎的敏感性和特异性分别为 81.3% 和 100.0%。结论在评估儿科 IBD 患者的炎症活动时,肠壁超声波与 FC 浓度显示出很强的相关性。
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Evaluation of bowel wall flow by color Doppler ultrasound in the assessment of inflammatory bowel disease activity in pediatric patients
Abstract Objective: To assess inflammatory bowel disease (IBD) activity with Doppler ultrasound in pediatric patients, comparing the accuracy of the ultrasound findings with that of the concentrations of fecal calprotectin (FC). Materials and Methods: In a consecutive series, we evaluated 53 examinations of 44 pediatric patients seen between 2014 and 2020: 28 with Crohn’s disease, 15 with ulcerative colitis, and one with IBD unclassified. The diagnosis of IBD was made in accordance with the Porto criteria. The alteration studied in the greatest detail was bowel wall flow, which was classified by the lead investigator and two pediatric radiologists, all of whom were blinded to the FC concentrations and the other ultrasound findings. Bowel wall flow was categorized as low if there were up to 2 Doppler ultrasound signals/cm2, moderate if there were 3-5 signals/cm2, and high if there were more than 5 signals/cm2. Results: The agreement among the radiologists was substantial (kappa = 0.73). In cases in which ultrasound showed low bowel wall flow, the median FC concentration was 92 µg/g (interquartile range, 33-661 µg/g), whereas it was 2,286 µg/g (interquartile range, 1,728-5,612 µg/g) in those in which ultrasound showed high bowel wall flow. In the sample as a whole, the sensitivity and specificity of ultrasound was 89.7% and 92.0%, respectively, for the detection of inflammatory activity; 95.5% and 90.9%, respectively, for the detection of Crohn’s disease; and 81.3% and 100.0%, respectively, for the detection of ulcerative colitis. Conclusion: Ultrasound of the bowel wall showed a strong correlation with FC concentrations in the assessment of inflammatory activity in pediatric patients with IBD.
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来源期刊
Radiologia Brasileira
Radiologia Brasileira Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
2.60
自引率
0.00%
发文量
75
审稿时长
28 weeks
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