The Evalue Of Abdominal Ultrasonography And Elastography In The The Evaluation The Activity And Curative Effect Of Crohn’s Disease

Objective To evaluate the clinical value of abdominal ultrasonography and elastography in evaluating the activity and therapeutic effect of Crohn’s disease(CD).Methods①We collected 10 healthy controls(HC)and 30 patients who were clinically diagnosed as active CD according to the diagnostic criteria in the consensus opinion on diagnosis and treatment of IBD in 2012.② The Best CDAI count was performed in all the patients,the SES-CD was calculated by colonoscopy,and the CTE score was recorded by small intestine CT.After that,the thickness of intestinal wall was measured by abdominal ultrasound,the SD value was measured by elastic imaging,and the CRP,ESR and FC in blood were measured at the same time.In the healthy control group,only abdominal ultrasound was used to measure the thickness of intestinal wall.③The corresponding treatment was selected according to the severity of the disease.④ The mucosal thickness,SD,and other relevant data of CD Patients before and after treatment were compared to analyze the correlation between the mucosal thickness、FC and CD activity,recurrence rate and the effect of elastic modulus on the drug treatment effect,and calculate the mucosal thickness and the best threshold of FC in diagnosing CD activityResults 1.There was a significant difference in the thickness of intestinal wall between the active stage and the remission stage.When the the thickness of intestinal wall was 3.70 mm as the threshold of the active stage,the sensitivity was 96.1%,the specificity was 85.7%,and the Youden index was 0.818.2.There was no significant difference in SD between active Period and remission Period.According to the decrease of CDAI<100,the treatment was ineffective.When SD was 8.79,the sensitivity was 100%,and the specificity was 93.6%.3.There were significant differences in CDAI,SES-CD,CTE score,CRP and ESR between the active and the remission Period.The thickness of intestinal wall was Positively correlated with CDAI,SES-CD,CTE score and CRP,but not with ESR.4.There was significant difference between FC in active Phase and remission Phase,and it was Positively correlated with the thickness of intestinal wall,CDAI,SES-CD,,CTE score,CRP and ESR.To use the FC to diagnose CD active Period,The results showed that the area under the curve was 0.982.When the threshold value of FC was 242.5 UG/g,the sensitivity was 96.1%,the specificity was 83.3%,and the Youden index was 0.794.5.When the thickness of intestinal wall was less than 3.15mm,FC was less than 224ug/g,the recurrence rate of CD was low.Conclusion 1.The measurement of the thickness of intestinal wall by transabdominal ultrasound is consistent with the assessment of CD activity by CDAI,SES-CD and CTE,so it can be used as an independent auxiliary index to judge the degree of inflammation.2.When the thickness of intestinal wall was less than 3.15mm,FC was less than 224ug/g,the recurrence rate of CD was low.3.The measurement of SD by elastic imaging is helpful to evaluate the degree of fibrosis in the intestinal segment of CD stenosis,so as to guide the clinical treatment.4.The correlation between faecal calprotectin and intestinal wall thickness,best CDAI,SES-CD,CTE score is also good in evaluating CD activity,which can help to judge the degree of CD inflammation and efficacy.When the FC is less than 224ug/g,the recurrence rate of CD is low.