Clinical value of preoperative intestinal ultrasound in predicting early postoperative recurrence in patients with Crohn's disease
10.3760/cma.j.cn131148-20250125-00050
- VernacularTitle:术前肠道超声预测克罗恩病患者术后早期复发的临床应用价值
- Author:
Zhuohua LIANG
1
;
Jie ZHOU
;
Wenjie CHENG
;
Si QIN
;
Guangjian LIU
Author Information
1. 中山大学附属第六医院超声科 广州市黄埔区中六生物医学创新研究院，广州 510655
- Publication Type:Journal Article
- Keywords:
Crohn's disease;
Early postoperative recurrence;
Intestinal ultrasound;
Mesenteric fat hypertrophy
- From:
Chinese Journal of Ultrasonography
2025;34(7):623-629
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of preoperative intestinal ultrasound parameters in predicting early postoperative recurrence（EPR）in patients with Crohn's disease（CD）.Methods:Ninety-five patients with CD who underwent I-stage intestinal resection at the Sixth Affiliated Hospital， Sun Yat-sen University from March 2015 to December 2020 were retrospectively enrolled. The patients were divided into EPR group （ n=50） and non-EPR （NEPR） group （ n=45） based on recurrence within one year postoperatively. Differences in preoperative intestinal ultrasound parameters including bowel wall thickness，bowel wall stratification， color Doppler grading， mesenteric fat hypertrophy （MFH） ， mesenteric lymphadenopathy， abscess/fistula， abdominal effusion， and clinical factors such as preoperative C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR） were compared between the two groups. The predictive values of ultrasound parameters with statistically significant differences between the two groups were analyzed. Univariate and multivariate Logistic regression analyses were used to identify independent predictive factors associated with EPR in patients with CD. Results:During the 1-year follow-up，EPR occurred in 52.6%（50/95）patients with CD. Among clinical factors，preoperative CRP and ESR levels showed statistically significant differences between the EPR and NEPR groups（all P<0.05）. For ultrasound parameters，the incidences of mesenteric fat hypertrophy（MFH）and abscess/fistula were significantly higher in the EPR group than the NEPR group（all P<0.05）. MFH demonstrated a significantly higher AUC value for predicting EPR compared to abscess/fistula（0.797 vs.0.617， P=0.002）. Univariate Logistic analysis showed that CRP，ESR，MFH and abscess/fistula were candidate variables for diagnosing EPR（all P<0.05）. Multivariate Logistic regression analysis indicated that MFH（ OR=13.800， P<0.001）and the laboratory measure CRP（ OR=1.015， P=0.030）were effective predictive factors for EPR. Conclusions:Preoperative intestinal ultrasound parameter MFH may serve as a valuable predictor for assessing EPR risk in patients with CD.
