Ultrasound elasticity imaging for detecting intestinal fibrosis and inflammation in rats and humans with Crohn's disease.
Ultrasound elasticity imaging for detecting intestinal fibrosis and inflammation in rats and humans with Crohn's disease.
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DOI：
10.1053/j.gastro.2011.07.027
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发表时间：
2011-09
期刊：
影响因子：
29.4
通讯作者：
Higgins PD
中科院分区：
文献类型：
--
作者：
Stidham RW;Xu J;Johnson LA;Kim K;Moons DS;McKenna BJ;Rubin JM;Higgins PD
肠纤维化导致克罗恩病（CD）的许多并发症。现有的生物标志物和成像方式在区分肠道炎症和纤维化方面缺乏足够的准确性。经皮超声弹性成像（UEI）是一种很有前途的、无创的测量组织力学性能的方法。我们假设UEI可以在结肠炎动物模型和CD患者中区分炎症性和纤维化性肠壁变化。雌性Lewis大鼠每周接受三硝基苯磺酸灌肠，产生急性炎症性结肠炎（n = 5）和慢性肠道纤维化（n = 6）模型。UEI扫描采用了一种新颖的斑点跟踪算法来估计组织应变。评估切除的肠段是否有炎症和纤维化。对连续7例狭窄性CD患者进行UEI研究，并通过体外弹性测量和组织病理学评估其切除的狭窄和正常肠段。经皮UEI归一化菌株在炎症性肠病（IBD）大鼠模型中能够区分急性炎症（- 2.07）和慢性纤维化（- 1.10）结肠，P = 0.037。经皮UEI归一化菌株也能在人CD中分化出狭窄小肠（- 0.87）和邻近正常小肠（- 1.99）（P = 0.0008），而且这一测量结果与体外弹性测量结果也有很好的相关性（r = - 0.81）。在IBD大鼠模型中，UEI可以区分炎性肠和纤维化肠，在一项针对CD患者的初步研究中，UEI可以区分纤维化肠和未受影响的肠。UEI代表了一项新技术，有可能成为衡量肠道纤维化进展的一种新的客观指标。需要对乳糜泻进行前瞻性临床研究。
Intestinal fibrosis causes many complications of Crohn’s disease (CD). Available biomarkers and imaging modalities lack sufficient accuracy to distinguish intestinal inflammation from fibrosis. Transcutaneous ultrasound elasticity imaging (UEI) is a promising, noninvasive approach for measuring tissue mechanical properties. We hypothesized that UEI could differentiate inflammatory from fibrotic bowel wall changes in both animal models of colitis and humans with CD. Female Lewis rats underwent weekly trinitrobenzene sulfonic acid enemas yielding models of acute inflammatory colitis (n = 5) and chronic intestinal fibrosis (n = 6). UEI scanning used a novel speckle-tracking algorithm to estimate tissue strain. Resected bowel segments were evaluated for evidence of inflammation and fibrosis. Seven consecutive patients with stenotic CD were studied with UEI and their resected stenotic and normal bowel segments were evaluated by ex vivo elastometry and histopathology. Transcutaneous UEI normalized strain was able to differentiate acutely inflamed (−2.07) versus chronic fibrotic (−1.10) colon in rat models of inflammatory bowel disease (IBD; P = .037). Transcutaneous UEI normalized strain also differentiated stenotic (−0.87) versus adjacent normal small bowel (−1.99) in human CD (P = .0008), and this measurement also correlated well with ex vivo elastometry (r = −0.81). UEI can differentiate inflammatory from fibrotic intestine in rat models of IBD and can differentiate between fibrotic and unaffected intestine in a pilot study in humans with CD. UEI represents a novel technology with potential to become a new objective measure of progression of intestinal fibrosis. Prospective clinical studies in CD are needed.