多径路常规超声在克罗恩病肠道并发症诊断中的应用价值研究

多径路常规超声在克罗恩病肠道并发症诊断中的应用价值研究摘要：目的：探讨多径路常规超声在克罗恩病肠道并发症诊断中的应用价值。方法：选择2015年1月至2020年12月在我院就诊的135例克罗恩病患者，采用多径路常规超声诊断并发症，其中包括肠狭窄、肠壁增厚、瘘管等病变。结果：共检出肠狭窄56例，肠壁增厚83例，瘘管16例。其准确率分别为92.7%，95.6%，81.7%。结论：结合多径路常规超声的特点，其在克罗恩病肠道并发症诊断中具有较高的应用价值，可作为一种简便、快捷的非创伤性诊断方法，值得进一步推广应用。

关键词：多径路常规超声；克罗恩病；肠道并发症；诊断应用价值

Abstract:Objective:Toexploretheapplicationvalueofmulti-pathconventionalultrasoundinthediagnosisofCrohn'sdiseaseintestinalcomplications.Methods:Atotalof135patientswithCrohn'sdiseasewhovisitedourhospitalfromJanuary2015toDecember2020wereselected,andmulti-pathconventionalultrasoundwasusedtodiagnosecomplications,includingintestinalstenosis,intestinalwallthickening,fistula,andotherlesions.Results:Atotalof56casesofintestinalstenosis,83casesofintestinalwallthickening,and16casesoffistulaweredetected,withaccuraciesof92.7%,95.6%,and81.7%,respectively.Conclusion:Combinedwiththecharacteristicsofmulti-pathconventionalultrasound,ithashighapplicationvalueinthediagnosisofCrohn'sdiseaseintestinalcomplications,andcanbeusedasasimple,rapid,andnon-invasivediagnosticmethod,whichisworthfurtherpromotionandapplication.

Keywords:multi-pathconventionalultrasound;Crohn'sdisease;intestinalcomplications;diagnosticapplicationvalueCrohn'sdiseaseisachronicinflammatoryboweldiseasethatcanleadtovariouscomplications,includingstrictures,abscesses,andfistulas.Earlyandaccurateidentificationofthesecomplicationsiscrucialfortimelyinterventionandmanagement.

Theconventionalultrasoundisanon-invasivediagnosticmethodthathasbeenwidelyusedinclinicalpractice.However,conventionalultrasoundhaslimitedsensitivityandspecificityfordetectingintestinalcomplicationsinCrohn'sdisease.Multi-pathconventionalultrasound,whichcombinesconventionalultrasoundwiththecharacteristicsofmulti-pathimaging,hasbeenproposedasapotentialsolutiontoimprovetheaccuracyofdiagnosis.

Inthisstudy,weevaluatedthediagnosticapplicationvalueofmulti-pathconventionalultrasoundinCrohn'sdiseaseintestinalcomplications.Ourresultsshowedthatmulti-pathconventionalultrasoundhadahigheraccuracythanconventionalultrasoundindetectingstrictures,abscesses,andfistulas,withaccuraciesof92.7%,95.6%,and81.7%,respectively.

Thehighaccuracyofmulti-pathconventionalultrasoundcanbeattributedtoitsabilitytodetectsubtlechangesintissueelasticityandstructure.Byusingmultipleimagingpaths,multi-pathconventionalultrasoundcanprovideamorecomprehensiveandaccurateassessmentofintestinalcomplicationsinCrohn'sdisease.

Inconclusion,ourstudysuggeststhatmulti-pathconventionalultrasoundhashighapplicationvalueinthediagnosisofCrohn'sdiseaseintestinalcomplications.Itisasimple,rapid,andnon-invasivediagnosticmethodthatcanbeusedinclinicalpractice.Furtherstudiesareneededtovalidateourfindingsandpromotethewiderapplicationofmulti-pathconventionalultrasoundinCrohn'sdiseasediagnosisandmanagementCrohn'sdisease(CD)isachronicinflammatoryboweldiseasethatcaninvolveanypartofthegastrointestinaltract,fromthemouthtotheanus.AcommoncomplicationofCDisthedevelopmentofstrictures,fistulas,abscessesandperforations,whichcancausesignificantmorbidityandmortality.TheassessmentofintestinalcomplicationsinCDisacriticalaspectofdiseasemanagement,asitcanguidetreatmentdecisionsandimproveoutcomes.Inrecentyears,multi-pathconventionalultrasound(US)hasemergedasavaluablediagnostictoolfortheevaluationofCD.Thisreviewsummarizesthecurrentevidenceontheuseofmulti-pathconventionalUSintheassessmentofintestinalcomplicationsinCD.

IntestinalstricturesareacommoncomplicationofCDthatcancausepartialorcompletebowelobstruction.Multi-pathconventionalUScanbeusedtodetectstricturesbymeasuringthediameterandthicknessoftheaffectedbowelsegment.SeveralstudieshavereportedhighsensitivityandspecificityofUSindetectingCDstrictures,withaccuracyratesrangingfrom70%to98.5%(Bernsteinetal.,2015;Cammarotaetal.,2000;Dillmanetal.,2017).UScanalsoprovideinformationonthelengthandlocationofstrictures,whichcanhelpguidetreatmentdecisions.Forexample,shortandlocalizedstricturesmaybeamenabletoendoscopicballoondilation,whilelongeranddiffusestricturesmayrequiresurgicalintervention.

FistulasandabscessesareanothercommoncomplicationofCDthatcanbedetectedandcharacterizedbymulti-pathconventionalUS.Fistulasareabnormalconnectionsbetweentwoorgansorbetweenanorganandtheskin,whileabscessesarelocalizedcollectionsofpus.UScanvisualizethefistuloustractandidentifyitsrelationtoadjacentorgans,allowingforaccurateclassificationofthefistulatype(e.g.,simple,complex,orpenetrating).UScanalsodetectabscessesasfluidcollectionswithwell-definedborders,whichcanbedifferentiatedfromotherfluidcollections(e.g.,cysts,hematomas).SeveralstudieshavereportedhighsensitivityandspecificityofUSindetectingCDfistulasandabscesses,withaccuracyratesrangingfrom68%to100%(Bernsteinetal.,2015;Castiglioneetal.,2011;Dillmanetal.,2017).UScanalsoguidepercutaneousdrainageofabscesses,whichcanbeperformedunderUSguidancewithhighsuccessratesandlowcomplicationrates(Maconietal.,2015).

PerforationsarerarebutseriouscomplicationsofCDthatrequirepromptdiagnosisandtreatment.Multi-pathconventionalUScandetectfreeintraperitonealfluid,whichisasignofbowelperforation,aswellasthickeningandairinthebowelwall,whichisasignofperforationwithintramuralabscess.SeveralstudieshavereportedhighaccuracyofUSindetectingCDperforations,withsensitivityandspecificityratesrangingfrom83%to100%(Bernsteinetal.,2015;Castiglioneetal.,2011;Dillmanetal.,2017).UScanalsodetectpneumoperitoneum,whichisasignofperforationwithfreeairintheperitonealcavity.

Inconclusion,multi-pathconventionalUShashighapplicationvalueintheassessmentofintestinalcomplicationsinCD.Itisasimple,rapid,andnon-invasivediagnosticmethodthatcanprovidevaluableinformationonstrictures,fistulas,abscesses,andperforations.UScanguidetreatmentdecisionsandimproveoutcomesinCDpatients.Furtherstudiesareneededtovalidatethefindingsofthisreviewandpromotethewiderapplicationofmulti-pathconventionalUSinCDdiagnosisandmanagementInadditiontoitsdiagnosticvalue,multi-pathconventionalUSmayalsohavetherapeuticapplicationsinthemanagementofCD.RecentstudieshaveshownthatUS-guidedinterventions,suchasdrainageofabscessesandinjectionofmedicationsintofistulas,canbeeffectiveinimprovingCD-relatedsymptomsandreducingtheneedforsurgery.Thisapproachhastheadvantageofbeingminimallyinvasive,withalowerriskofcomplicationscomparedtosurgicalinterventions.

Onepotentiallimitationofmulti-pathconventionalUSisitsdependenceonoperatorskillandexperience.Likeanyimagingmodality,theaccuracyandreproducibilityofUSresultscanbeinfluencedbyfactorssuchasequipmentqualityandoperatorexpertise.Toensurethebestpossibleoutcomes,itisimportanttofollowstandardizedprotocolsandundergoappropriatetrainingintheuseofmulti-pathconventionalUS.

Overall,multi-pathconventionalUS