Application of shear wave elastography in differentiating fibrotic stricture from inflammatory stricture in patients with Crohn's disease
10.3760/cma.j.cn101480-20231204-00075
- VernacularTitle:剪切波弹性成像在克罗恩病炎症性狭窄和纤维性狭窄鉴别诊断中的应用
- Author:
Shihui LI
1
;
Manying LI
;
Ren MAO
;
Xiaoyan XIE
;
Yujun CHEN
Author Information
1. 中山大学附属第一医院超声医学科，广州 510080
- Publication Type:Journal Article
- Keywords:
Crohn's disease;
Shear wave elastography;
Stricture;
Fibrosis
- From:
Chinese Journal of Inflammatory Bowel Diseases
2024;08(5):364-370
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the feasibility of shear wave elastography (SWE) in differentiating inflammatory and fibrotic strictures in Crohn's disease (CD) .Methods:A cross-sectional survey study was conducted. The patients with stricture-type CD who underwent SWE examination at the First Affiliated Hospital of Sun Yat-sen University from January 2020 to June 2023 were continuously collected. The general data, laboratory examination indicators, and ultrasound examination indicators were collected. Laboratory examination indicators included C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Ultrasound examination indicators included intestinal wall thickness, proximal bowel dilation, intestinal wall layer structure, Limberg grading, and the elasticity indicator SWE value. Patients were divided into inflammatory stricture group and fibrotic stricture group by using a modified fibrosis score of the narrowed intestine. Statistical analysis was performed to compare the differences in clinical data between the two groups, and Spearman correlation analysis was used to evaluate the correlation between ultrasound indicators and fibrosis score. Receiver operating characteristic (ROC) curves were plotted, and the diagnostic efficacy of SWE for inflammatory stricture and fibrotic stricture was calculated.Results:A total of 60 CD patients [44 men, 16 women; mean age, 34.3 ± 11.1 years; mean disease duration 60 (24, 117) months] were included. There were 43 patients in the inflammatory stricture group and 17 in the fibrotic stricture group. The differences in CRP ( P = 0.049), intestinal wall thickness ( P = 0.020), intestinal wall layer structure ( P = 0.001), and SWE value ( P < 0.001) between the two groups were statistically significant, but the differences in other indicators were not statistically significant (all P > 0.05). Intestinal wall thickness, intestinal wall layer structure, and SWE value were all positively correlated with fibrosis scores (all r s >0.3). In distinguishing inflammatory stricture from fibrotic stricture, a cut-off value of 15.9 kPa for SWE value yielded a sensitivity of 0.824, a specificity of 0.791, and the area under curve was 0.850 (95% CI: 0.740~0.952, P<0.001) . Conclusion:SWE examination can be used for the differential diagnosis of inflammatory and fibrotic strictures in CD, providing more diagnostic evidence for patients with stricture-type CD.
