Single measurement of bowel wall thickness using intestinal ultrasonography in children with ulcerative colitis.

IF 1 4区医学 Q3 PEDIATRICS

Pediatrics International Pub Date : 2024-01-01 DOI:10.1111/ped.15721

Masano Otani, Takeru Okuhira, Atsushi Yoden, Emiri Kaji, Keisuke Inoue, Tomoki Aomatsu, Kimitaka Takitani, Akira Ashida

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引用次数: 0

Abstract

Background: Endoscopic monitoring of disease activity in patients with ulcerative colitis (UC) is important. However, frequent colonoscopic examinations are difficult to perform because of their invasiveness, especially in children. Bowel wall thickness (BWT) measurement using intestinal ultrasonography and fecal calprotectin (FC) measurement are useful noninvasive evaluation methods.

Methods: We retrospectively analyzed BWT and FC levels and evaluated the Mayo endoscopic subscore (MES) using colonoscopy in pediatric patients with UC during the same period. The BWT was evaluated using the maximum BWT (mBWT), which was the maximum value of each colonic BWT; the sum of BWT (sBWT), which was the sum of each colonic BWT; and the sum of the adjusted BWT (saBWT), which was corrected using sBWT.

Results: In 54 procedures from 40 patients, FC, mBWT, sBWT, and saBWT were significantly different between MES 0-1 and MES 2. The agreement between BWT and MES 2 was 193 out of 216 segments (89.4%). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FC were 68.8%, 84.2%, 64.7%, 86.5%, and 79.6% respectively, while those of saBWT were 81.2%, 89.5%, 76.5%, 91.9%, 87.0%, respectively.

Conclusions: BWT in each colonic segment, particularly saBWT, was more useful than FC for detecting moderate colonic inflammation (MES 2) in pediatric patients with UC. Therefore, intestinal ultrasonography may be helpful in the less invasive management of pediatric patients with UC.

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使用肠道超声波对溃疡性结肠炎患儿的肠壁厚度进行一次性测量。

背景：通过内窥镜监测溃疡性结肠炎（UC）患者的疾病活动非常重要。然而，频繁的结肠镜检查因其侵入性而难以进行，尤其是对儿童而言。使用肠道超声波测量肠壁厚度（BWT）和测量粪便钙蛋白（FC）是有用的无创评估方法：我们回顾性分析了同期 UC 儿童患者的 BWT 和 FC 水平，并使用结肠镜评估了梅奥内镜子评分（MES）。对BWT的评估采用最大BWT（mBWT），即各结肠BWT的最大值；BWT总和（sBWT），即各结肠BWT的总和；以及调整BWT总和（saBWT），即用sBWT进行校正：结果：在 40 名患者的 54 次手术中，FC、mBWT、sBWT 和 saBWT 在 MES 0-1 和 MES 2 之间存在显著差异。在 216 个节段中，BWT 和 MES 2 的一致性为 193 个（89.4%）。FC 的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 68.8%、84.2%、64.7%、86.5% 和 79.6%，而 saBWT 的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 81.2%、89.5%、76.5%、91.9% 和 87.0%：在检测儿童 UC 患者结肠中度炎症（MES 2）方面，结肠各段的 BWT（尤其是 saBWT）比 FC 更有用。因此，肠道超声波检查有助于对儿童 UC 患者进行微创治疗。

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

Pediatrics International 医学-小儿科

CiteScore

2.00

自引率

7.10%

发文量

519

审稿时长

12 months

期刊介绍： Publishing articles of scientific excellence in pediatrics and child health delivery, Pediatrics International aims to encourage those involved in the research, practice and delivery of child health to share their experiences, ideas and achievements. Formerly Acta Paediatrica Japonica, the change in name in 1999 to Pediatrics International, reflects the Journal''s international status both in readership and contributions (approximately 45% of articles published are from non-Japanese authors). The Editors continue their strong commitment to the sharing of scientific information for the benefit of children everywhere. Pediatrics International opens the door to all authors throughout the world. Manuscripts are judged by two experts solely upon the basis of their contribution of original data, original ideas and their presentation.