Intra-Cavitary Contrast-Enhanced Ultrasound: a Novel Radiation-Free Method to Detect Abscess Associated Penetrating Disease in Crohn's Disease.
Intra-Cavitary Contrast-Enhanced Ultrasound: a Novel Radiation-Free Method to Detect Abscess Associated Penetrating Disease in Crohn's Disease.
复制标题
腔内对比增强超声：一种检测克罗恩病脓肿相关穿透性疾病的新型无辐射方法。
DOI：
10.1093/ecco-jcc/jjy209
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发表时间：
2018
影响因子：
8
通讯作者：
Xie Xiao-Yan
中科院分区：
文献类型：
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作者：
Mao Ren;Chen Yu-Jun;Chen Bai-Li;Xie Xiao-Hua;He Yao;Chen Shu-Ling;Xu Ming;Li Xue-Hua;Zhang Jian;Song Xin-Ming;Zeng Zhi-Rong;Rimola Jordi;Rieder Florian;Ben-Horin Shomron;Chen Min-Hu;Xie Xiao-Yan
背景与目的克罗恩病（Crohn 'sdisease，CD）的常见并发症是穿透性疾病.确定瘘管的存在和瘘管的解剖定义对于决定适当的治疗策略至关重要。我们的目的是评估腔内超声造影[IC-CEUS]的诊断准确性检测瘘道相关的脓肿在CD patients.MethodsIn这一前瞻性队列研究，连续CD患者怀疑有腹腔内脓肿，谁被称为美国引导下抽吸被招募。在超声引导下穿刺脓肿抽吸和引流后，立即将稀释的造影剂[SonoVue]注射到脓肿腔中进行IC-CEUS。IC-CEUS的诊断准确性，证明存在瘘道进行了比较，计算机断层扫描肠造影/磁共振肠造影[CTE/MRE]，使用手术和大体病理结果作为参考standard.Results31例谁进行了IC-CEUS和随后的手术被列入最终分析。IC-CEUS在31名参与者中的26名中显示瘘管/窦道，灵敏度和特异性分别为86.7%（95%置信区间[CI]，68.4-95.6%）和100% [95% CI，5.5-100.0%]。此外，IC-CEUS正确显示了13名参与者的瘘管/窦道，而没有在CTE/MRE上描绘瘘管/窦道。结合IC-CEUS和CTE/MRE，29例患者[93.5%，29/31]的瘘/窦道得到清晰显示。IC-CEUS手术的平均持续时间为8.6 min [范围5.0-12.0]。IC-CEUS procedure.ConclusionIn this pilot study，IC-CEUS准确描绘了CD患者腹腔内脓肿相关瘘管/窦道的解剖学定义。作为一种无辐射、安全的技术，IC-CEUS可作为CTE/MRE的替代/替代方法用于检测CD患者的穿透性疾病。
Background and AimPenetrating disease is a common condition complicating Crohn’s disease [CD]. Establishing the presence of a fistula and the anatomical definition of the fistulous tracts are essential for deciding on appropriate treatment strategies. We aimed to assess the diagnostic accuracy of intra-cavitary contrast-enhanced ultrasound [IC-CEUS] for the detection of a fistulous tract associated with abscesses in CD patients.MethodsIn this prospective cohort study, consecutive CD patients suspected of having an intra-abdominal abscess, who were referred for US-guided aspiration were recruited. IC-CEUS was performed by injecting diluted contrast agent [SonoVue] into the abscess cavity immediately following the ultrasound-guided needle abscess aspiration and drainage. The diagnostic accuracy of IC-CEUS in demonstrating the presence of fistulous tracts was compared with that of computed tomography enterography/magnetic resonance enterography [CTE/MRE], using surgical and gross pathological findings as the reference standard.ResultsThirty-one patients who underwent IC-CEUS and subsequent surgery were included in the final analysis. IC-CEUS demonstrated fistulous/sinus tracts in 26 of 31 participants with a sensitivity and specificity of 86.7 % (95% confidence interval [CI], 68.4–95.6%) and 100% [95% CI, 5.5–100.0%], respectively. Moreover, IC-CEUS correctly demonstrated fistulous/sinus tracts in 13 participants without delineation of fistulous/sinus tracts on CTE/MRE. Combining IC-CEUS and CTE/MRE, the fistula/sinus tract was clearly demonstrated in 29 patients [93.5%, 29/31]. The mean duration of the IC-CEUS procedure was 8.6 min [range 5.0–12.0]. No severe adverse events occurred during the IC-CEUS procedure.ConclusionIn this pilot study, IC-CEUS accurately delineated the anatomical definition of fistulous/sinus tracts associated with intra-abdominal abscesses in CD patients. As a radiation-free and safe technique, IC-CEUS may be used as an alternative/adjunctive method to CTE/MRE for detecting penetrating disease in patients with CD.