Clinical Relevance of Transabdominal Ultrasonography and Magnetic Resonance Imaging in Patients With Inflammatory Bowel Disease of the Terminal Ileum and Large Bowel

Pascu, Maria; Ab, Roznowski; Müller, Hans-Peter; Adler, Andreas; Wiedenmann, Bertram; Au, Dignass

doi:10.1097/00054725-200407000-00008

Cited by 123 publications

(106 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…MRE is very precise in determining the location and extension of the inflammatory lesions (sensitivity 74%, specificity 91%) in CD (5), which is very close to the precision demonstrated by CT enterography (18) and greater than the precision of ultrasound for locations in the jejunum and proximal ileum (19). In our series, the majority of the patients in whom an extension study was performed using MRE, disease activity was found in the jejunum and proximal ileum which led to a change in the therapeutic management of these patients due to having extensive disease.…”

Section: Discussionmentioning

confidence: 63%

Using of magnetic resonance enterography in the management of Crohn's disease of the small intestine: First year of experience

Mendoza

González-Lama

Taxonera

et al. 2012

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

Objective: to describe the experience at two tertiary centres during the first year of use of magnetic resonance enterography (MRE) for the management of Crohn's disease (CD): indications and influence of the technique in clinical decision making.Materials and methods: retrospective descriptive study in which patients who underwent MRE were included consecutively. Epidemiological and clinical data were collected from the patients, as well as the indication for the study and how it influenced clinical decision making in the 10 days following the radiological study.Results: 24 MREs were performed in suspected CD and 126 known CD; partial bowel obstruction in 53 patients (42%), monitoring of medical treatment in 34 (27%), due to incomplete ileocolonoscopy in 16 (13%), extension study of the small intestine in 15 (12%) and suspected complicated CD in 8 patients (6%). The MRE influenced in a change in treatment in 83 (55.3%) patients: 16 (10.7%) started with immunosuppressants, 41 (27.3%) with antiTNFa were started on or switched, 15 (10%) were ordered surgery and in 3 (2%) changed from combined therapy to monotherapy. The MRE had less influence on clinical decision making in the group in which the indication was suspected CD (p < 0.05).Conclusions: the use of MRE helped on decision making in more than half of patients, especially with regards to decisions related to the use of biological therapies and the indication for surgery. MRE was less useful in suspected CD patients

show abstract

Section: Discussionmentioning

confidence: 63%

Using of magnetic resonance enterography in the management of Crohn's disease of the small intestine: First year of experience

Mendoza

González-Lama

Taxonera

et al. 2012

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

show abstract

“…Transabdominal ultrasound is a simple and noninvasive procedure, and the measured bowel wall thickness is known to correlate with degree of inflammation (4)(5)(6). Although it has been reported that bowel wall thickness decreases early as the disease improves, the decrease rate of an early wall thickening has been studied, whether or not the decrement of colonic wall thickness can predict the response to CAP therapy has not been published.…”

Section: Discussionmentioning

confidence: 99%

Possible Role of Early Transabdominal Ultrasound in Patients Undergoing Cytapheresis for Active Ulcerative Colitis

Yoshida¹,

Kobayashi²,

Ueno³

et al. 2011

Intern. Med.

View full text Add to dashboard Cite

Background Cytaphresis (CAP) is an effective modality in the treatment of active ulcerative colitis (UC), but the time lag before a notable clinical response on scheduled therapy frequently causes a significant delay in the modification of treatment. We previously reported that the clinical response after CAP was predicted by early application of transabdominal ultrasound (TAUS), but the predictability of long-term outcome after CAP still remains uncertain. Methods Patients: Twenty-six patients with active UC who received CAP were followed for 1 year. In addition to CAP they received pharmaceutical regimens, such as corticosteroid, 5-aminosalicylic acid, and immunomodulator, as indicated clinically. The mean UC-DAI score was 9.7 before CAP, and 3.2 at 1 year after CAP. Prognostic factor: Total colonic wall thickness was measured by TAUS at 2 to 3 weeks after the initiation of the treatment, and decrement from baseline was calculated. Early ultrasonographic response (EUR) was defined as a decrement statistically. UC-DAI score of 2 or less at 1 year was defined as sustained clinical remission. Score of 6 or more was defined as clinical relapse. Results EUR was defined as a decrement in wall thickness by at least 2.5 mm from the baseline. EUR was noted in 11 patients, and the remaining 15 did not attain EUR. Outcome measures: In the UC-DAI score measured at 1 year after initiation of treatment 90.9% of patients with EUR, whereas 40.0% with non-EUR (p<0.05) showed sustained clinical remission. Regarding relapse, within 1 year 9.1% of patients with EUR relapsed whereas 46.7% with non-EUR (p<0.05) relapsed. Conclusion Early application of TAUS may predict the long-term clinical outcome after CAP in patients with active UC.

show abstract

“…Some studies showed a good comparability between the results of MRE and ultrasound, in some ultrasound was even superior [12,13,14,20]. Others suggested that MRE was superior to ultrasound, particularly regarding the localization of affected bowel segments and the detection of fistulas [11].…”

Section: Discussionmentioning

confidence: 99%

“…Some suggest MRE to be superior to ultrasound, particularly regarding the localization of affected bowel segments and the detection of fistulas [11]. Other studies showed a good comparability between the results of MR enterography and ultrasound [12,13,14]. …”

Section: Introductionmentioning

confidence: 99%

Clinical Feature and Bowel Ultrasound in Crohn’s Disease – Does Additional Information from Magnetic Resonance Imaging Affect Therapeutic Approach and When Does Extended Diagnostic Investigation Make Sense?

Girlich¹,

Ott²,

Strauch³

et al. 2010

Digestion

View full text Add to dashboard Cite

Background/Aims: Some suggest MRI to be superior to ultrasound in Crohn’s disease. We analyzed how often MR enterography (MRE) following a routine ultrasound leads to a change in therapeutic decision. Material and Methods: We retrospectively evaluated 47 patients with Crohn’s disease undergoing routine ultrasound examination. Actual medical history, complete blood count, C-reactive protein (CRP), and sonographic findings were assessed independently by two specialists who retrospectively provided a therapeutic proposal. Additionally, all patients received MRE. Thereafter, the specialists had to provide a new therapeutic concept regarding all the available information. Results: Evaluation of the rectum was not successful by ultrasound, but MRE gave good results. Only 1 of 7 abscesses was identified sonographically. Three of the abscesses missed at sonography were localized in the perirectal/perianal region. MRE detected more inflamed bowel segments, but ultrasound assessment of anatomically fixed bowel parts showed good recognition by MRE. With increasing CRP values, we found more positive results of ultrasound and MRE. Therapeutic change was suggested in only 18 patients. Conclusions: Ultrasound should be performed by an experienced examiner, and a proctological examination should be added. MRE is justified in cases of discrepancy between clinical findings and the results of diagnostic ultrasound and, moreover, if Crohn’s lesions are suspected at sites proximal to the terminal or neoterminal ileum.

show abstract

Clinical Relevance of Transabdominal Ultrasonography and Magnetic Resonance Imaging in Patients With Inflammatory Bowel Disease of the Terminal Ileum and Large Bowel

Abstract: This study provides strong evidence that US should be considered as a first-choice method for follow-up of patients with IBD of the terminal ileum and large bowel.

Cited by 123 publications

References 53 publications

Using of magnetic resonance enterography in the management of Crohn's disease of the small intestine: First year of experience

Using of magnetic resonance enterography in the management of Crohn's disease of the small intestine: First year of experience

Possible Role of Early Transabdominal Ultrasound in Patients Undergoing Cytapheresis for Active Ulcerative Colitis

Clinical Feature and Bowel Ultrasound in Crohn’s Disease – Does Additional Information from Magnetic Resonance Imaging Affect Therapeutic Approach and When Does Extended Diagnostic Investigation Make Sense?

Contact Info

Product

Resources

About