Determining the Accuracy and Interobserver Agreement of 4 Ultrasound Scores in Crohn's Disease Assessment: Correlations With Endoscopy.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinical and Translational Gastroenterology Pub Date : 2025-01-10 DOI:10.14309/ctg.0000000000000812

Jing Qin, Li Ma, Meng-Yuan Zhou, Wen-Bo Li, Meng-Su Xiao, Zi-Han Niu, Hong Yang, Qing-Li Zhu

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引用次数: 0

Abstract

Introduction: Gastrointestinal ultrasound (GIUS) is recommended for monitoring Crohn's disease (CD). GIUS scores are used to quantify CD activity. Among them, International Bowel Ultrasound Segmental Activity Score (IBUS-SAS), Bowel Ultrasound Score (BUSS), Simple Ultrasound Score, and Simple Ultrasound Score for Crohn's Disease are most commonly used. The aim of this study was to compare and correlate the performance of such indicators with endoscopic activity and to calculate interobserver agreement.

Methods: Consecutive patients with CD at our hospital between June 2015 and July 2021 were retrospectively enrolled. All patients underwent ileocolonoscopy after medical treatment. GIUS was performed within 2 weeks, and 4 GIUS scores were independently calculated. Receiver operating characteristic curve analyses were used to determine a cutoff value. Cohen kappa (κ) coefficient was calculated to estimate the agreement between GIUS findings.

Results: A total of 106 patients with CD were enrolled. 80.2% (85/106) were endoscopic active (Simple Endoscopic Score for Crohn's disease ≥3), and 8.49% (9/106) were severe cases (Simple Endoscopic Score for Crohn's disease ≥9). All GIUS features (bowel wall thickness, color Doppler signs, bowel wall stratification, inflammatory signals at the mesentery) were statistically significant in assessing CD activity ( P < 0.05). IBUS-SAS showed the highest area under the curve (0.98; 95% CI: 0.96-1.00) and specificity (95.2%) for a cutoff value of 46.50. However, IBUS-SAS had only moderate agreement (Cohen κ = 0.427; P < 0.001). BUSS had substantial interobserver agreement (Cohen κ = 0.947; P < 0.001), with a similar diagnostic value (sensitivity, 100.0%; accuracy, 95.3%; area under the curve of 0.96 [95% CI: 0.91-1.00] for a cutoff value of 4.58).

Discussion: GIUS score is an efficient and reliable method to assess CD activity. BUSS achieved a high accuracy and excellent interobserver agreement, which is more suitable for treatment assessment.

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确定克罗恩病评估中四个超声评分的准确性和观察者之间的一致性：与内窥镜检查的相关性

背景：胃肠超声（GIUS）被推荐用于克罗恩病（CD）的监测。GIUS评分用于量化CD活动。其中，最常用的是IBUS-SAS（国际肠超声节段活动评分）、BUSS（肠超声评分）、Simple- us（简单超声评分）和SUS-CD（克罗恩病简单超声评分）。本研究旨在比较和关联这些指标的性能与内窥镜活动，并计算观察者之间的协议。方法：回顾性纳入2015年6月至2021年7月在我院连续就诊的CD患者。所有患者在治疗后均行回肠结肠镜检查。2周内进行GIUS，独立计算四次GIUS评分。采用受试者工作特征（ROC）曲线分析确定截断值。计算Cohen's kappa（κ）系数以估计GIUS结果之间的一致性。结果：共纳入106例CD患者。80.2%（85/106）为内镜活动（SES-CD≥3），8.49%（9/106）为重症（SES-CD≥9）。所有GIUS特征（肠壁厚度、彩色多普勒征象、肠壁分层、肠系膜炎症信号）在评估CD活动方面均具有统计学意义(结论：GIUS评分是评估CD活动的有效、可靠的方法。BUSS具有较高的准确性和良好的观察者间一致性，更适合于治疗评估。

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

Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.00

自引率

0.00%

发文量

114

审稿时长

16 weeks

期刊介绍： Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.