Value of ultrasound in the diagnosis of secondary loss of response in pediatric Crohn′s disease treated with Infliximab
10.3760/cma.j.cn131148-20230328-00169
- VernacularTitle:超声在英夫利西单抗治疗儿童克罗恩病继发性失应答诊断中的价值
- Author:
Xin WEI
1
;
Yanchun CUI
;
Yanxiu HU
;
Yue XIN
;
Xiaoling XIONG
;
Qingli ZHU
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院超声医学科，北京 100730
- Keywords:
Ultrasonography;
Pediatric Crohn′s disease;
Infliximab;
Secondary loss of response
- From:
Chinese Journal of Ultrasonography
2023;32(9):796-800
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of ultrasound in the diagnosis of secondary loss of response in children with Crohn′s disease at maintenance stage treated with Infliximab.Methods:From January 2017 to December 2021, 51 children with Crohn′s disease who received Infliximab treatment and clinical response in the Beijing Children′s Hospital Affiliated to Capital Medical University were retrospectively analyzed, and whether there was secondary loss of response during the maintenance period was observed. The ultrasound examination results at the 14th week of treatment were collected to understand the correlation between ultrasound examination of intestinal wall and peri-intestinal healing and secondary loss of response.Results:A total of 15 out of 51 patients (29.4%) experienced secondary loss of response during treatment follow-up up to 54 weeks. Compared to children with continuous response, children with secondary loss of response had a thicker intestinal wall at week 14 of treatment [5.0 (3.8, 6.0)mm compared to 3.0 (2.0, 4.0)mm, P<0.001], and a higher proportion of intestinal wall stratified structure disappearance [8/15 (53.33%) compared to 3/36 (8.33%), P<0.001]. When intestinal wall thickness>3.0 mm, the sensitivity was 0.955, and the specificity was 0.483. The sensitivity and specificity of clear diagnosis of secondary loss of response in intestinal wall stratification were 0.727 and 0.825, respectively. The sensitivity and specificity of combined diagnosis for secondary loss of response were 0.933 and 0.611, respectively. Conclusions:At the 14th week of treatment with Infliximab in children with Crohn′s disease, the thickness of intestinal wall measured by ultrasound being more than 3.0 mm and the disappearance of intestinal wall statified structure provide important information for the diagnosis of secondary loss of response.
