Evaluation of intestinal ultrasound for disease activity assessment in patients with inflammatory bowel disease: A cross-sectional study at a tertiary centre in Malaysia.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Kuan Yee Lim, Raja Affendi Raja Ali, Zhiqin Wong, Faizah Mohd Zaki, Juliana Fairuz Maktar, Khairul Najmi Muhammad Nawawi
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Abstract

Background: The use of intestinal ultrasound (IUS) in the management of inflammatory bowel disease (IBD) is emerging. We aim to determine the performance of IUS in the assessment of disease activity in IBD.

Methods: This is a prospective cross-sectional study of IUS performed on IBD patients in a tertiary centre. IUS parameters including intestinal wall thickness, loss of wall stratification, mesenteric fibrofatty proliferation, and increased vascularity were compared with endoscopic and clinical activity indices.

Results: Among the 51 patients, 58.8% were male, with a mean age of 41 years. Fifty-seven percent had underlying ulcerative colitis with mean disease duration of 8.4 years. Against ileocolonoscopy, IUS had a sensitivity of 67% (95% confidence interval (CI): 41-86) for detecting endoscopically active disease. It had high specificity of 97% (95% CI: 82-99) with positive and negative predictive values of 92% and 84%, respectively. Against clinical activity index, IUS had a sensitivity of 70% (95% CI: 35-92) and specificity of 85% (95% CI: 70-94) for detecting moderate to severe disease. Among individual IUS parameters, presence of bowel wall thickening (>3 mm) had the highest sensitivity (72%) for detecting endoscopically active disease. For per-bowel segment analysis, IUS (bowel wall thickening) was able to achieve 100% sensitivity and 95% specificity when examining the transverse colon.

Conclusions: IUS has moderate sensitivity with excellent specificity in detecting active disease in IBD. IUS is most sensitive in detecting a disease at transverse colon. IUS can be employed as an adjunct in the assessment of IBD.

肠道超声对炎症性肠病患者疾病活动性评估的评估:马来西亚一家三级中心的横断面研究。
背景:肠道超声(IUS)在炎症性肠病(IBD)治疗中的应用正在兴起。我们的目的是确定宫内节育器在评估IBD疾病活动性方面的表现。方法:这是一项在三级中心对IBD患者进行的宫内节育器前瞻性横断面研究。将IUS参数,包括肠壁厚度、壁分层损失、肠系膜纤维脂肪增生和血管增加,与内镜和临床活动指数进行比较。结果:51例患者中,男性占58.8%,平均年龄41岁。57%的患者有潜在的溃疡性结肠炎,平均病程8.4年。对于回结肠镜检查,IUS检测内镜活动性疾病的敏感性为67%(95%置信区间(CI):41-86)。其特异性高达97%(95%可信区间:82-99),阳性和阴性预测值分别为92%和84%。相对于临床活动指数,IUS检测中重度疾病的敏感性为70%(95%CI:35-92),特异性为85%(95%CI:70-94)。在单个IUS参数中,肠壁增厚(>3 mm)对检测内镜活动性疾病的敏感性最高(72%)。对于每个肠段的分析,IUS(肠壁增厚)在检查横结肠时能够达到100%的灵敏度和95%的特异性。结论:IUS在检测IBD活动性疾病方面具有中等的敏感性和良好的特异性。IUS在检测横结肠疾病方面最敏感。IUS可作为IBD评估的辅助手段。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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