Article

Ultrasound scanning may reduce the need for barium radiology in the assessment of small-bowel Crohn's disease.

Division of Infection, Inflammation and Repair, Southampton University School of Medicine, Southampton, UK.
Acta Paediatrica (impact factor: 2.07). 05/2004; 93(4):479-81. pp.479-81
Source: PubMed

ABSTRACT Bowel wall thickening on transabdominal ultrasound scanning (USS) correlates well with Crohn's disease (CD) activity. However, the role of USS in the assessment of CD has not been fully defined. This study compared USS and barium follow-through (BaFT) in the assessment of CD.
A retrospective case series was undertaken of 24 children with CD who underwent USS and BaFT during the same period of clinical disease activity.
For terminal ileum abnormality, all 13 cases with abnormal USS had abnormality on BaFT. USS did not detect five cases with affected terminal ileum and two cases with isolated proximal small-bowel CD.
BaFT is a more sensitive indicator of small-bowel CD than USS. USS has good positive predictive value of distal small-bowel CD, but BaFT should be performed in the presence of a normal USS where there is strong clinical evidence of CD.

0 0
 · 
0 Bookmarks
 · 
20 Views
  • Source
    Article: Contrast-enhanced ultrasonographic evaluation of inflammatory activity in Crohn's disease.
    Vincenzo Migaleddu, Antonio M Scanu, Emilio Quaia, Paolo Cossu Rocca, Maria Pina Dore, Domenico Scanu, Lorenza Azzali, Giuseppe Virgilio
    [show abstract] [hide abstract]
    ABSTRACT: We sought to test the diagnostic accuracy of ultrasound (US), color Doppler US (CD-US), and contrast-enhanced US (CE-US) in the evaluation of inflammatory activity in patients with Crohn's disease (CD), and to correlate the findings of these sonographic studies with inflammatory activity, as scored by the CD activity index (CDAI). Patients with CD were enrolled in the study. Radiologists performing the scans were blinded to clinical status. Baseline US, CD-US, and CE-US examinations were conducted with high-frequency probes (8-14 and 5-7 MHz) before and after injection of sulfur hexafluoride-filled microbubbles. The diagnostic accuracy of baseline US, CD-US, and CE-US were calculated by using the endoscopic and histologic findings as reference standards and correlated with the CDAIs by using the Pearson linear correlation coefficient. Forty-seven patients (20 men; 27 women; mean age +/- SD, 38 +/- 14 years) with a CDAI > 150 (n = 30) or < 150 (n = 17), were recruited. CE-US showed the highest performance, with 93.5% sensitivity, 93.7% specificity, and 93.6% overall accuracy. CE-US revealed 3 bowel wall perfusion patterns after microbubble injection: submucosal enhancement and inward and outward transparietal enhancement. The linear correlation coefficient for CE-US versus CDAI was 0.74 (P < .0001); for baseline US (assessing thickness, length, and multilayer appearance of the diseased bowel) versus the CDAI, the coefficients were 0.68 (P < .0001), 0.47 (P = .0009), and 0.60 (P < .0001), respectively; and for CD-US versus CDAI the coefficient was 0.73 (P < .0001). CE-US has a high sensitivity and specificity in detecting inflammatory activity and a strong correlation with the CDAI.
    Gastroenterology 05/2009; 137(1):43-52. · 11.68 Impact Factor
  • Source
    Article: Sonographic evaluation of inflammatory bowel disease: a prospective, blinded, comparative study.
    A Ronald Bremner, Mark Griffiths, Julie D Argent, Joanna J Fairhurst, R Mark Beattie
    [show abstract] [hide abstract]
    ABSTRACT: Children with inflammatory bowel disease (IBD) undergo invasive and repeated investigations, including contrast radiology and endoscopy. To assess transabdominal sonography of the colon and distal ileum compared to colonoscopy and barium radiology in known or suspected IBD. A prospectively recruited cohort of 44 children (median age 12 years, range 3.5-16.5 years; 24 males) underwent transabdominal sonography prior to colonoscopy (n=33) or barium follow-through (n=25). Diagnoses were: Crohn disease (n=25), ulcerative colitis (n=12), indeterminate colitis (n=1), normal (n=6). Bowel wall thickness (BWT) and endoscopic severity were compared in 153 colonic segments. No difference was found between normal and mildly affected segments. BWT was less in normal bowel than moderate (P<0.001) or severe (P<0.001) lesions. Where BWT was >2.9 mm, sensitivity for moderate/severe disease was 48%, specificity 93%, positive predictive value 83% (likelihood ratio 7). Barium radiology showed terminal ileum abnormality in ten patients (40%). Where ileal BWT was >2.5 mm, comparative sensitivity was 75%, specificity 92%, positive predictive value 88% (likelihood ratio 9). Superior mesenteric artery Doppler did not correlate with disease severity. Increased BWT has good positive predictive value for moderate/severe disease in the colon proximal to the rectum (>3 mm), and terminal ileum (>2.5 mm). BWT below this cannot exclude moderate/severe mucosal lesions.
    Pediatric Radiology 09/2006; 36(9):947-53. · 1.67 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

24 children
 
abnormal USS
 
BaFT
 
barium follow-through
 
Bowel wall thickening
 
cases
 
clinical disease activity
 
Crohn's disease
 
distal small-bowel CD
 
normal USS
 
proximal small-bowel CD
 
retrospective case series
 
sensitive indicator
 
small-bowel CD
 
terminal ileum
 
terminal ileum abnormality
 
transabdominal ultrasound scanning
 
USS
 

A R Bremner