Accuracy of Transperineal Ultrasonography for Assessing Rectal Lesions in Paediatric Ulcerative Colitis: A Prospective Study
Accuracy of Transperineal Ultrasonography for Assessing Rectal Lesions in Paediatric Ulcerative Colitis: A Prospective Study
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经会阴超声检查评估小儿溃疡性结肠炎直肠病变的准确性：一项前瞻性研究
DOI：
10.1093/ecco-jcc/jjad035
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Shimizu Toshiaki
中科院分区：
文献类型：
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作者：
Jimbo Keisuke;Hosoi Kenji;Suzuki Mitsuyoshi;Kyodo Reiko;Maruyama Kimiko;Arai Nobuyasu;Sato Masamichi;Miyata Eri;Hoshino Eri;Kudo Takahiro;Shimizu Toshiaki
背景和目的经腹超声检查 [TAUS] 在评估溃疡性结肠炎 [UC] 活动方面似乎与结肠镜检查相当，但其在直肠评估方面的准确性较低。在本研究中，将经会阴超声检查 [TPUS] 评估直肠活动的准确性与结肠镜检查在儿科 UC 病例中的准确性进行了比较。方法对儿科 UC 病例中粪便钙卫蛋白 [FCP] 值以及 TPUS 和结肠镜检查结果进行前瞻性比较。将 TPUS 评估的直肠壁增厚 [RWT] 和直肠壁流量 [RWF] 与结肠镜检查结果进行比较，并在 TAUS 上进行测量，并评估每个发现的一致性率。 结果 30 例 Mayo 内镜评分 [MES] 0-1 UC 病例和 57 例 MES 2-3 UC 病例入组。 FCP、RWT和RWF在两组之间显示出显着差异[p< 0.05]。 RWT 和 RWF 是 UC 内镜活动的独立预测因子，RWT ≥ 4.5 mm 且 RWF 阳性时，敏感性为 95.8%，特异性为 100%。 MES 2-3 中 TPUS 和 TAUS 结果之间的一致性为中等至一般，而 MES 0-1 中的一致性为一般至较差。 TAUS 和 TPUS 的超声检查者之间的一致性都很好。结论 TPUS 可以评估 UC 的直肠活动性，其准确性与内窥镜检查相当。如果可以通过 TPUS 和 TAUS 对全结肠进行准确的超声筛查，则可能可以重复评估短期治疗反应。
Background and AimsTransabdominal ultrasonography [TAUS] appears comparable to colonoscopy for evaluating ulcerative colitis [UC] activity, but it has low accuracy in rectal evaluation. In this study, the accuracy of transperineal ultrasonography [TPUS] for evaluating rectal activity was compared to that of colonoscopy in paediatric UC cases.MethodsFaecal calprotectin [FCP] values and TPUS and colonoscopic findings were compared prospectively in paediatric UC cases. Rectal wall thickening [RWT] and rectal wall flow [RWF] on power Doppler evaluated by TPUS were compared with the colonoscopy findings and were also measured on TAUS and assessed for the concordance rate of each finding.ResultsThirty Mayo endoscopic sub-score [MES] 0–1 UC cases and 57 MES 2–3 UC cases were enrolled. FCP, RWT and RWF showed significant differences between the two groups [p< 0.05]. RWT and RWF were independent predictors of UC endoscopic activity, showing sensitivity of 95.8% and specificity of 100% with RWT ≥ 4.5 mm and positive RWF. The concordance rates between TPUS and TAUS findings in MES 2–3 were moderate to fair, whereas those in MES 0–1 were fair to poor. The concordance rates between ultrasonic examiners were good for both TAUS and TPUS.ConclusionsTPUS may evaluate rectal activity of UC with accuracy comparable to endoscopy. If accurate ultrasonic screening for the total colon can be performed by TPUS and TAUS, repeated evaluation of short-term treatment response may be possible.