METHOD FOR ULTRASONIC DIFFERENTIAL DIAGNOSIS OF STRICTURES OF INTESTINAL WALL OF COLON AND/OR SMALL INTESTINES IN CROHN'S DISEASE

摘要

FIELD: medicine.;SUBSTANCE: invention relates to coloproctology and radiation diagnostics, can be used for ultrasonic differential diagnosis of stricture and/or small intestine intestinal wall strictures in Crohn's disease. Preliminary segments of altered intestinal walls of the colon and/or small intestines are formed in the form of strictures formation by means of percutaneous ultrasound examination of the intestine of the patient using a convection sensor with the frequency of study 3.5 MHz throughout the colonic and/or small intestine. Results of the performed ultrasonic examination in B-mode and Doppler sonography in the energy mode using a linear sensor with frequency of 5–10 MHz are used to determine localization of strictures, intestinal wall thickness and distribution of layers in the intestinal wall. Using the compression ultrasonic elastography, examining each detected change in the colonic and/or small intestine using a linear sensor with a test frequency of 7.5 MHz in real time. Compression ultrasonic elastography is used to perform differential diagnostics of inflammatory and fibrotic strictures in the colonic and/or enteric intestines with simultaneous analytical assessment of patient's elastogram by colour combination and quantitative index of stiffness coefficient of analyzed tissues with their mapping by shades of green, yellow and red colours, and more rigid tissues - with shades of blue colour. Stiffness coefficient is defined as ratio of stiffness of altered segment of colon and/or small intestine to rigidity of adjacent fibre of their mesentery, respectively, or anterior abdominal wall. If observing thickening of colonic and/or small intestine walls due to all layers or absence of differentiation of layers with simultaneous mosaic type of colour mapping with uniform distribution of areas of blue and green colours, presence of single loci of yellow and red colours and a certain stiffness coefficient less than 3.45 standard units. diagnosing an inflammatory stricture in the colon and / or small intestine. And if blue colour is prevailing in mosaic type of colour mapping in changed segment of colon and / or small intestine with transition to mesentery and stiffness coefficient more than 3.45 standard units, fibrotic stricture of colon and/or intestinal segments is diagnosed. Results of elastography are compared with results of pathomorphological studies of a remote macropreparation of a colon and/or a small intestine with the presence of a stricture.;EFFECT: method provides objectivity and detail of the ultrasonic diagnostics data of the structural changes of the colonic and/or intestinal walls accompanying the strictures and the sufficient degree of accuracy of the differential diagnosis of the inflammatory and fibrous changes of the colonic and/or intestinal wall by analyzing a set of criteria obtained by ultrasound examination in B-mode, Doppler sonography in the energy mode and compression ultrasonic elastography of the colon and/or small intestine in Crohn's disease.;1 cl, 3 ex