Terapevticheskii arkhiv · 2025
[Experience in the application of ultrasound indices for assessing the activity of inflammatory bowel diseases].
Аннотация на английскомСтатьяНазвание и аннотация: Оригинал на русском
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Mukhametova D D, Minnemullin I M, Akchurina O E, Odintsova A K, Abdulganieva D I
Аннотация
AIM: To evaluate the diagnostic value of ultrasound (US) parameters and indices for assessing the active inflammatory bowel diseases (IBD).
MATERIALS AND METHODS: The study included 115 patients with IBD, 41 (36%) patients were with ulcerative colitis (UC) and 74 (64%) - with Crohn's disease (CD). Transabdominal US examination of the intestine was performed on Sonoscape S2N, with a bowel wall thickness (BWT) of 3 mm considered the norm. To assess activity in UC, the Milan Ultrasound Criteria (MUC) score was used, and in CD - International Bowel Ultrasound Segmental Activity Score (IBUS-SAS).
RESULTS: In active UC BWT (5.91 [4.87; 6.95] mm) was greater than in remission (2.9 [2.6; 3.1] mm; p = 0.003). For active UC diagnosis BWT greater than 3 mm had sensitivity (Se) of 90.5% and specificity (Sp) of 70.6%. The MUC in exacerbation (9 [7.88; 11.8]) was higher than in remission (4.2 [3.64; 4.9]; p < 0.001). In 31 (89%) patients in exacerbation, the MUC was higher than 6.2 (Se 88.9%, Sp 87.5%), and in 34 (97%) at a threshold of 5.18 (Se 96.3%, Sp 87.5%). In active CD, BWT (4.9 [3.8; 6.6] mm) was greater than in remission (3.18 [2.6; 3.5]; p = 0.0001), with Se 87.0%, Sp 71.4%. The IBUS-SAS in active CD (46.8 [27; 71.5]) was higher than the remission (12.6 [11.2; 30.2]; p = 0.001). At a threshold of 37.5, the IBUS-SAS had Se 92.6%, Sp 61.5%, and at 45.2, Se 92.6%, Sp 87.2%.
CONCLUSION: US imaging is a useful and effective tool for assessing IBD activity; a threshold value of the MUC score of 5.18 and IBUS-SAS of 45.2 suggests better diagnostic value for differentiating between exacerbation and remission.
MATERIALS AND METHODS: The study included 115 patients with IBD, 41 (36%) patients were with ulcerative colitis (UC) and 74 (64%) - with Crohn's disease (CD). Transabdominal US examination of the intestine was performed on Sonoscape S2N, with a bowel wall thickness (BWT) of 3 mm considered the norm. To assess activity in UC, the Milan Ultrasound Criteria (MUC) score was used, and in CD - International Bowel Ultrasound Segmental Activity Score (IBUS-SAS).
RESULTS: In active UC BWT (5.91 [4.87; 6.95] mm) was greater than in remission (2.9 [2.6; 3.1] mm; p = 0.003). For active UC diagnosis BWT greater than 3 mm had sensitivity (Se) of 90.5% and specificity (Sp) of 70.6%. The MUC in exacerbation (9 [7.88; 11.8]) was higher than in remission (4.2 [3.64; 4.9]; p < 0.001). In 31 (89%) patients in exacerbation, the MUC was higher than 6.2 (Se 88.9%, Sp 87.5%), and in 34 (97%) at a threshold of 5.18 (Se 96.3%, Sp 87.5%). In active CD, BWT (4.9 [3.8; 6.6] mm) was greater than in remission (3.18 [2.6; 3.5]; p = 0.0001), with Se 87.0%, Sp 71.4%. The IBUS-SAS in active CD (46.8 [27; 71.5]) was higher than the remission (12.6 [11.2; 30.2]; p = 0.001). At a threshold of 37.5, the IBUS-SAS had Se 92.6%, Sp 61.5%, and at 45.2, Se 92.6%, Sp 87.2%.
CONCLUSION: US imaging is a useful and effective tool for assessing IBD activity; a threshold value of the MUC score of 5.18 and IBUS-SAS of 45.2 suggests better diagnostic value for differentiating between exacerbation and remission.