Imaging and Advanced TechnologyContrast-Enhanced Ultrasonographic Evaluation of Inflammatory Activity in Crohn's Disease
Section snippets
Patients
This was a single-center study. Consecutive patients with Crohn's disease were enrolled. Clinical status and the CDAI,19 according to previously defined criteria,20 were designated by clinicians within 5 days before the sonographic assessment (baseline US, CD-US, and CE-US) and not >2 days after starting corticosteroid therapy. Twenty-six small bowel follow-throughs and 21 double-contrast bowel enemas were carried out, according to the sites of the lesions. Endoscopy with biopsy was performed
Results
Over a period of 2 years (February 2004 to December 2005), 59 consecutive patients referred to our hospital for abdominal symptoms or pain and suspected Crohn's disease underwent sonographic assessment consisting of baseline US, CD-US, and CE-US. Twelve patients were excluded because of lack of a histologically proven diagnosis of Crohn's disease (n = 3), incomplete sonographic findings (n = 4), an interval of >5 days between the sonographic assessment and CDAI evaluation (n = 3), or use of
Discussion
The recent introduction of new drugs, such as targeted monoclonal antibodies, in the treatment of Crohn's disease, has led to a need for noninvasive methods to assess the efficacy of pharmacologic treatment. Evaluation of inflammatory activity in Crohn's disease, a crucial aspect of treatment planning and monitoring, is currently based on a sum of clinical data and imaging findings.27 Among the various imaging methods, ultrasonography has experienced the most impressive technological advances,
Acknowledgments
The authors thank Dr Silvio Cavuto for the revision of the statistical chapter of the study.
References (49)
- et al.
The radiology of inflammatory bowel disease
Med Clin North Am
(1994) - et al.
The role of endoscopy in inflammatory bowel disease
Med Clin North Am
(1994) - et al.
Ultrasound and magnetic resonance imaging assessment of active bowel segments in Crohn's disease
Clin Radiol
(2002) - et al.
Development of a Crohn's disease activity index
Gastroenterology
(1976) - et al.
Predictability of the postoperative course of Crohn's disease
Gastroenterology
(1990) Crohn's disease
Lancet
(2002)Ultrasound demonstration of bowel wall thickness in inflammatory bowel disease
Clin Radiol
(1984)- et al.
Detection of Crohn's disease by ultrasound
Gastroenterology
(1982) - et al.
Diagnosis of Crohn's disease
Dig Dis Sci
(1980) Radiography versus colonoscopy in evaluation of colonic IBD
Inflamm Bowel Dis
(1995)
Idiopathic inflammatory bowel disease: endoscopic-radiologic correlation
Radiology
A prospective study of the technical feasibility of ileoscopy at colonoscopy
Scand J Gastroenterol
Differentiating ulcerative colitis from Crohn disease in children and young adults: report of a working group of the North American Society for Pediatric Gastroenterology Hepatology and Nutrition and the Crohn's and Colitis Foundation of America
J Pediatr Gastroenterol Nutr
Wireless capsule endoscopy and small intestine contrast ultrasonography in recurrence of Crohn's disease
Inflamm Bowel Dis
Crohn Disease of the small bowel: preliminary comparison among CT enterography, capsule endoscopy, small-bowel follow-through and ileoscopy
Radiology
MRI evaluation of inflammatory activity in Crohn's disease
Am J Roentgenol
MR imaging in patients with Crohn disease: value of T2- versus T1-weighted gadolinium-enhanced MR sequences with use of an oral super paramagnetic contrast agent
Radiology
Crohn disease: mural attenuation and thickness at contrast-enhanced CT enterography—correlation with endoscopic and histologic findings of inflammation
Radiology
Computed tomography in the evaluation of Crohn disease
Am J Roentgenol
CT of inflammatory bowel disease
Radiol Clin North Am
Ultrasound examination of the small bowel: comparison with enteroclysis in patients with Crohn disease
Abdom Imaging
Sonographic assessment of the normal and abnormal bowel wall in nondiverticular ileitis and colitis
Abdom Imaging
Role of US in detection of Crohn disease: meta-analysis
Radiology
Cited by (0)
This article has an accompanying continuing medical education activity on page 372. Learning Objective: Upon completion of this CME exercise, successful learners will be able to demonstrate the achievement of knowledge to choose the best diagnostic approach in the different clinical features that Crohn disease and its progression present, as a non-invasive technique associated with greater patient comfort, CE-US has significant diagnostic accuracy in the assessment of Crohn's disease activity.
Conflicts of Interest The authors disclose no conflicts.