Клинико-лабораторные и ультразвуковые показатели в оценке активности воспаления при болезни Крона

Abstract

The evolution of ultrasound equipment and the growing experience of investigators have increased the role of intestinal ultrasound in the evaluation of the gastrointestinal tract in patients with Crohn's disease. Purpose of the study: to assess the degree of activity of Crohn's disease using transabdominal ultrasound examination of the intestine Methods. We prospectively evaluated 30 patients aged 18–70 years with an established diagnosis of Crohn's disease. Patients underwent clinical assessment of Crohn's disease activity, laboratory assessment included C-reactive protein and fecal calprotectin, and endoscopic activity was assessed using the simplified endoscopic Crohn's disease assessment method. Segments of the colon and terminal ileum were assessed using intestinal ultrasound. The study was performed by a sonographer using a LOGIQ E9 machine using convex (2.5–5 MHz) and linear [(5–10 MHz) transducers. The study was carried out without special preparation, on an empty stomach, without additional contrast enhancement. Certain ultrasound parameters (intestinal wall thickness, vascularization pattern, intestinal wall architectural disorder, fibrofatty proliferation, mesenteric lymphadenopathy, ascites) were used to determine the sonographic assessment of activity. Statistical analysis was performed using Statistical Package for the Social Sciences (IBM SPSS Statistics 23) Results. Changes in intestinal wall thickness were found in all parts of the intestine, as well as increased vascularity according to the Limberg scale. Intestinal wall thickness was significantly correlated with changes in the level of C-reactive protein, fecal calprotectin and moderately correlated with the clinical activity index. Conclusions. Our study shows that transabdominal intestinal ultrasound is an effective and easy-to-use tool for assessing Crohn's disease activity and monitoring disease progression in routine practice.