切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2014, Vol. 10 ›› Issue (06) : 801 -803. doi: 10.3877/cma.j.issn.1673-5250.2014.06.023

所属专题: 文献

论著

彩色多普勒超声检查对儿童克罗恩病的诊断意义
翁志媛1,*,*(), 肖雪1, 张又祥1   
  1. 1. 510180 广东省广州市第一人民医院儿科
  • 收稿日期:2014-08-06 修回日期:2014-11-02 出版日期:2014-12-01
  • 通信作者: 翁志媛

Color Doppler Ultrasound Diagnosis of Crohn Disease in Children

Zhiyuan Weng1(), Xue Xiao1, Youxiang Zhang1   

  1. 1. Department of Pediatrics, Guangzhou First People' s Hospital, Guangzhou 510180, Guangdong, China
  • Received:2014-08-06 Revised:2014-11-02 Published:2014-12-01
  • Corresponding author: Zhiyuan Weng
  • About author:
    (Corresponding author : Weng Zhiyuan, Email : )
引用本文:

翁志媛, 肖雪, 张又祥. 彩色多普勒超声检查对儿童克罗恩病的诊断意义[J/OL]. 中华妇幼临床医学杂志(电子版), 2014, 10(06): 801-803.

Zhiyuan Weng, Xue Xiao, Youxiang Zhang. Color Doppler Ultrasound Diagnosis of Crohn Disease in Children[J/OL]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2014, 10(06): 801-803.

目的

探讨彩色多普勒超声在儿童克罗恩病(CD)诊断中的意义。

方法

选择2005年1月至2013年5月于广州市第一人民医院儿科就诊并经彩色多普勒超声检查诊断为CD的32例患儿为研究对象,男性患儿为12例,女性为20例,年龄为7~15岁。采用彩色多普勒超声诊断仪进行超声检查,观察病变肠管位置及内部回声、测量病变肠管厚度,对增厚的肠管改用高频探头,仔细观察肠管壁内部回声以及内部血流分布的变化情况,详细记录其结果并进行统计学分析。本研究遵循的程序符合广州市第一人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,并与受试对象监护人签署临床研究知情同意书。

结果

彩色多普勒超声检查诊断的32例CD患儿中,28例与经纤维结肠镜检查诊断结果一致,诊断一致率为87.5%。其中,13例(40.63%)患儿在空肠或回肠形成包块,7例(21.88%)患儿伴升结肠病变,6例(18.75%)患儿肠腔可见多处狭窄,5例(15.63%)患儿从空肠至回肠均有病变,1例(3.13%)患儿肠腔可见1处狭窄。儿童CD所致肠管狭窄较重,好发于肠系膜缘,其近端明显扩张,黏膜增粗形成均匀一致的小充盈缺损影,表现为典型的假息肉状或"鹅卵石"样。

结论

儿童CD的彩色多普勒超声声像图具有特殊性改变,能为临床CD的诊断提供较准确的诊断依据,对临床制定治疗方案和疗效观察具有重要价值。

Objective

To discuss the color Doppler ultrasound diagnosis of Crohn disease (CD) in children.

Methods

A total of 32 hospitalized cases of CD who were diagnosed by color Doppler ultrasound from January 2005 to May 2013 were selected into this study. The position and internal lesions of intestinal lesions, thickness of intestinal lesions, internal echo of intestinal wall were observed by color Doppler ultrasonography. Then distributions of internal blood flow were observed by high frequency probe. Clinical data of CD children were recorded and retrospectively analyzed. The study protocol was approved by the Ethical Review Board of Investigation of Guangzhou First People's Hospital. Informed consent was obtained from all participates' patients.

Results

The color Doppler ultrasonography results showed that, among 32 cases, 28 cases in accordance with clinical diagnosis by fibro-colonoscope, and the accordance rate was 87.5%. Among them, 13 cases (40.63%) with the jejunum and ileum bag piece,7 cases (21.88%) with ascending colon lesions, 6 cases (18.75%) with several visible lumen stenosis, 5 cases (15.63%) with lesions from the jejunum to ileum,1 case (3.13%) with only one visible lumen stenosis. Pediatric intestinal canal stenosis caused by CD was heavier, and occured in mesentery. Its proximal obvious expansion, enlargement of mucous membrane filling with defect shadow, showed the typical false polypoid or pebbles.

Conclusions

CD had special color Doppler ultrasonographic changes which could provide more accurate evidence for clinical diagnosis and treatment.

[1]
Sands BE, Katz S, Wolf DC, et al. A randomised, double-blind, sham-controlled study of granulocyte/ monocyte apheresis for moderate to severe Crohn's disease [J]. Gut, 2013, 62(9): 1288–1294.
[2]
McCabe RP Jr, Chow CJ, Rothenberger DA. Duodenal-pleural fistula in Crohn's disease: successful long-term medical management [J]. Inflamm Bowel Dis,2013,19(3):E38–E39.
[3]
Tlaxca JL, Rychak JJ, Ernst PB, et al. Ultrasound-based molecular imaging and specific gene delivery to mesenteric vasculature by endothelial adhesion molecule targeted microbubbles in a mouse model of Crohn's disease [J]. J Control Release, 2013, 165 (3) : 216–225.
[4]
Alters SE, McLaughlin B, Spink B, et al. GLP2-2G-XTEN: a pharmaceutical protein with improved serum half-life and efficacy in a rat Crohn's disease model [J]. PLoS One, 2012, 7(11): e50630.
[5]
Yu SY, Qi R. Role of bad in podocyte apoptosis induced by puromycin aminonucleoside [J]. Transplant Proc, 2013, 45 (2): 569–573.
[6]
Russo E, Petts G, Lloyd T, et al. PMO-255 The expression of interleukin 2 receptor in intestinal resection specimens from patients with Crohn' s disease as assessed by immunohistochemistry[J]. Gut, 2012, 61(Suppl 2) : A179–A179.
[7]
杭桂芳,武心萍,丁文波.克罗恩病的超声诊断价值[J].中华现代影像学杂志,2006(6):538–539.
[8]
Eaden J A, Ford AC. Efficacy of granulocyte/monocyte apheresis for moderate to severe Crohn's disease [J]. Gut, 2013, 62 (4): 653.
[9]
Qi R, Li W, Yu S. FK506 inhibits the mice glomerular mesangial cells proliferation by affecting the transforming growth factor-β and Smads signal pathways [J]. Ren Fail, 2014, 36(4) : 589–592.
[10]
Peyrin-Biroulet L, Billioud V, D'Haens G, et al. Development of the Paris definition of early Crohn' s disease for disease-modification trials: results of an international expert opinion process [J]. Am J Gastroenterol, 2012, 107(12) : 1770–1776.
[11]
Burmester G R, Panaccione R, Gordon K B, et al. Adalimumab: long-term safety in 23 458 patients from global clinical trials in rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis and Crohn's disease[J]. Ann Rheumat Dis, 2013, 72(4): 517–524.
[12]
刘畅,徐辉雄,刘畅.进一步提高经腹超声评估炎症性肠病的水平[J].世界华人消化杂志,2013,21(32):3467–3472.
[13]
曾美英,吴春根,程英升.炎症性肠病分子影像学的研究进展[J].世界华人消化杂志,2014,22(23):3424–3429.
[14]
宋敏.小肠间质瘤的临床诊治分析[J].中国医药指南,2014,12 (24):11–13.
[15]
Tye GA, Desser TS. MDCT of the Small Bowel [J]. Appl Radiol, 2012, 41(8) : 6–17.
[16]
李元新.克罗恩病肠梗阻的外科治疗[J].中华消化外科杂志,2014, 13(8) : 12–15.
[17]
Sandborn WJ, Colombel JF, D'Haens G, et al. Association of baseline C-reactive protein and prior anti-tumor necrosis factor therapy with need for weekly dosing during maintenance therapy with adalimumab in patients with moderate to severe Crohn' s disease [J]. Curr Med Res Opin, 2013, 29(5): 483–493.
[18]
Bakker SF, Dik VK, Witte BI, et al. Increase in bone mineral density in strictly treated Crohn' s disease patients with concomitant calcium and vitamin D supplementation [J]. J Crohns Colitis, 2013, 7(5) : 377–384.
[19]
Burmester GR, Panaccione R, Gordon KB, et al. Adalimumab: long-term safety in 23 458 patients from global clinical trials in rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis and Crohn's disease [J]. Ann Rheum Dis, 2013, 72(4): 517–524.
[20]
Basseri RJ, Nemeth E, Vassilaki ME, et al. Hepcidin is a key mediator of anemia of inflammation in Crohn' s disease [J]. J Crohns Colitis, 2013, 7(8): e286–e291.
[1] 王亚红, 蔡胜, 葛志通, 杨筱, 李建初. 颅骨骨膜窦的超声表现一例[J/OL]. 中华医学超声杂志(电子版), 2024, 21(11): 1089-1091.
[2] 陶宏宇, 叶菁菁, 俞劲, 杨秀珍, 钱晶晶, 徐彬, 徐玮泽, 舒强. 右心声学造影在儿童右向左分流相关疾病中的评估价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(10): 959-965.
[3] 屈翔宇, 张懿刚, 李浩令, 邱天, 谈燚. USP24及其共表达肿瘤代谢基因在肝细胞癌中的诊断和预后预测作用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 659-662.
[4] 赵林娟, 吕婕, 王文胜, 马德茂, 侯涛. 超声引导下染色剂标记切缘的梭柱型和圆柱型保乳区段切除术的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 634-637.
[5] 熊鹰, 林敬莱, 白奇, 郭剑明, 王烁. 肾癌自动化病理诊断:AI离临床还有多远?[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 535-540.
[6] 王秋生. 胆道良性疾病诊疗策略[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 779-782.
[7] 袁雨涵, 杨盛力. 体液和组织蛋白质组学分析在肝癌早期分子诊断中的研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 883-888.
[8] 中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[9] 郑大雯, 王健东. 胆囊癌辅助诊断研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 769-773.
[10] 张琛, 秦鸣, 董娟, 陈玉龙. 超声检查对儿童肠扭转缺血性改变的诊断价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 565-568.
[11] 李浩, 陈棋帅, 费发珠, 张宁伟, 李元东, 王硕晨, 任宾. 慢性肝病肝纤维化无创诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 863-867.
[12] 谭瑞义. 小细胞骨肉瘤诊断及治疗研究现状与进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 781-784.
[13] 王子阳, 王宏宾, 刘晓旌. 血清标志物对甲胎蛋白阴性肝细胞癌诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 677-681.
[14] 陈慧, 邹祖鹏, 周田田, 张艺丹, 张海萍. 皮肤镜对头皮红斑性皮肤病辅助鉴别诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 692-698.
[15] 胡云鹤, 周玉焯, 付瑞瑛, 于凡, 李爱东. CHS-DRG付费制度下GB1分组住院费用影响因素分析与管理策略探讨[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 568-574.
阅读次数
全文


摘要