1 浜田内科胃腸科放射線部Department of Radiology, Hamada Medical Office
2 浜田内科胃腸科消化器内科Department of Gastroenterology, Hamada Medical Office
目的：大腸憩室炎例での超音波所見をGrade分類し，炎症の程度や重症度を推察できるか検討した．
対象と方法：対象は当院にて大腸憩室炎と診断された98例．方法は，超音波所見より三つのGradeに分類し，性別，年齢，部位について検討した．次にWBC/CRPとの関係性，CT所見との一致率，治療方針についてGradeと比較検討した．
結果と考察：分類はGrade 1から順に29例，60例，9例であった．性別，年齢，部位では有意差は認めなかった．WBCとCRPの平均値は，WBCはGrade 1から順に8,907/µL, 11,205/µL, 13,122/µL. CRPはGrade 1から順に3.2 mg/dL, 5.9 mg/dL, 11.0 mg/dLであった．有意差検定ではWBC: p＝0.0001, CRP: p＝0.00004と有意差を認めた．Grade 3で指摘した膿瘍形成を疑う液体貯留，後腹膜内ガス像，憩室壁の連続性の評価について，kappa係数を用いたCT所見との一致率はそれぞれ0.25, 0.55, 0.00であった．治療方針はGrade 1（外来治療24例，入院治療5例），Grade 2（28例，32例），Grade 3（0例，9例）であった．
結語：大腸憩室炎における超音波検査所見をGrade分類することは炎症程度や重症化リスクを推察することができ有用性があると思われた．
Purpose: We investigated the relationship between ultrasound findings, inflammatory markers, and the severity of diverticulitis in colorectal diverticulitis patients.
Subject and method: We enrolled 98 patients diagnosed with colorectal diverticulitis by abdominal ultrasound in our clinic. Based on the ultrasound findings we classified them into three grades of severity and compared their sex age, location of diverticulitis, inflammatory data (white blood cell count [WBC], C-reactive protein [CRP]), computed tomography (CT) findings, and clinical course.
Results and considerations: Of the 98 cases, there were 29, 60, and 9 classified as Grades 1, 2, and 3, respectively. There was no significant difference in sex, age or the location of the diverticulitis. The average WBC count and average CRP level were 8907/µL and 3.2 mg/dL, respectively, in the Grade 1 group, 11205/µL and 5.9 mg/dL, respectively, in the Grade 2 group, and 13122/µL and 11.0 mg/dL, respectively, in the Grade 3 group. There was a significant difference in the WBC average (p＝0.0001) and CRP (p＝0.00004). The value of the kappa coefficient between ultrasound findings and CT findings in the Grade 3 group was as follows: 0.25 in cases with abscess, 0.55 in cases with retroperitoneal gas, and 0.00 in cases with diverticular wall interruption. There were 5 cases (17%) in the Grade 1 group, 32 cases (53%) in the Grade 2 group, and 9 cases (100%) in the Grade 3 group, who were hospitalized for treatment.
Conclusion: Grading according to ultrasound findings in patients with colorectal diverticulitis correlated with inflammatory data and the severity of diverticulitis. This is a useful indicator on which to base treatment.
Key words: diverticulitis; ultrasound; grade classification
© 2023 一般社団法人日本超音波検査学会© 2023 Japanese Society of Sonographers
This page was created on 2023-04-07T14:28:15.746+09:00
This page was last modified on 2023-05-15T10:22:14.000+09:00
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