Sonographic findings in ischemic colitis in 58 patients
Sonographic findings in ischemic colitis in 58 patients
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DOI：
10.2214/ajr.184.3.01840777
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发表时间：
2005-03-01
影响因子：
5
通讯作者：
López, A
中科院分区：
文献类型：
--
作者：
Ripollés, T;Simó, L;López, A
OBJECTIVE.本研究的目的是描述58例缺血性结肠炎患者的超声检查结果，并评估是否有任何结果与透壁坏死的存在或发展有关。我们回顾了5.5年内诊断为缺血性结肠炎的患者的病史。62例患者接受了超声检查。缺血性结肠炎的超声表现谱是基于原始成像报告，分析结肠异常及其相关改变的存在。在研究的第二部分，我们根据有无透壁坏死将患者分为两组，并比较各组的超声表现。10例患者在住院期间进行了超声随访研究。超声检查对结肠异常定性的前瞻性敏感性为93.5%（58/62例患者）。58例患者中有57例检测到节段性受累，其中47例（81%）为左侧结肠炎。受累肠平均长度为19 cm，平均肠壁厚度为7.6 mm。38例患者（66%）保留了结肠壁分层。在16例患者（28%）中观察到结肠周围脂肪改变。在80%的患者中，增厚的肠壁中没有或几乎看不到彩色多普勒血流。结肠周围脂肪改变是唯一与透壁性坏死显著相关的超声变量（p = 0.004）。在所有具有良好临床病程的患者中观察到超声检查评估的改善。在透壁性坏死的患者中，超声检查没有显示改善。超声检查是一种有价值的技术，用于检测缺血性结肠炎引起的结肠异常。在这项研究中，结肠周围脂肪改变或超声随访研究中无改善是与透壁性坏死相关的因素。
OBJECTIVE. The purpose of this study was to describe the sonographic findings of 58 patients with proven ischemic colitis and to evaluate whether any of the findings are related to the presence or development of transmural necrosis.MATERIALS AND METHODS. We reviewed the histories of patients diagnosed with ischemic colitis over a period of 5.5 years. Sixty-two patients had undergone sonographic examinations. The spectrum of sonographic findings in ischemic colitis was based on the original imaging report, with an analysis of the presence of colonic abnormalities and their associated alterations. In the second part of the study, we divided the patients into two groups according to the presence or absence of transmural necrosis, and the sonographic findings of each group were compared. Ten patients had sonographic follow-up studies during their hospital stay.RESULTS. The prospective sensitivity of sonography for the characterization of colonic abnormalities was 93.5% (58/62 patients). Segmental involvement was detected in 57 of the 58 patients, with left-sided colitis in 47 (81%). The mean length of bowel involved was 19 cm, with a mean wall thickness of 7.6 mm. Colon wall stratification was preserved in 38 patients (66%). Altered pericolic fat was observed in 16 patients (28%). Absence of or barely visible color Doppler flow in the thickened bowel wall was recorded in 80% of patients. Altered pericolic fat was the only sonographic variable significantly associated with the presence of transmural necrosis (p = 0.004). Improvement as assessed on sonography was observed in all patients with a good clinical course. In patients with transmural necrosis, sonography did not show improvement.CONCLUSION. Sonography is a valuable technique for the detection of colonic abnormalities resulting from ischemic colitis. In this study, altered pericolic fat or the absence of improvement in sonographic follow-up studies were factors associated with transmural necrosis.