Contrast-enhanced ultrasonography in the evaluation of Crohn disease activity in children: comparison with histopathology

Ponorac, Slavojka; Dahmane, Raja; Urlep, Darja; Ključevšek, Damjana

doi:10.1007/s00247-020-04870-3

Cited by 8 publications

(15 citation statements)

References 32 publications

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“…Endoscopic disease activity was determined at the time of procedure using the validated SES-CD. 10 Disease activity was defined as follows: inactive or remission (0-2) and mild (3)(4)(5)(6)(7)(8)(9)(10), moderate (11)(12)(13)(14)(15)(16)(17)(18)(19), or severe (>19) (Figure 1). Only patients with complete ileocolonic examination were included in the final analysis.…”

Section: Methodsmentioning

confidence: 99%

“…With reference to the results of our previous study, which showed that the PE parameter has the highest performance in detecting CD activity in children, only PE was assessed in our current study. PE threshold values for delineation between inactive disease and different degrees of disease activity were also previously determined by histopathology scores, as follows 8 : PE 6.9 to discriminate mild from moderate/severe CD activity (sensitivity: 72.2%, specificity: 100%), and PE 3.2 to discriminate inactive disease from mild disease (sensitivity: 58%, specificity: 100%).…”

Section: Methodsmentioning

confidence: 99%

“…Quantitative contrast-enhanced ultrasound (CEUS) has been suggested as an alternative modality to fill this gap. 8 It is a novel imaging modality that uses intravenous ultrasound contrast agent (UCA) for objective quantification of bowel wall perfusion. 9 In addition, it also permits evaluation of disease activity in bowel not attainable to endoscopy assessment.…”

mentioning

confidence: 99%

“…This being said, substantial interest exists for a non‐invasive and objective method that accurately reflects bowel wall inflammation. Quantitative contrast‐enhanced ultrasound (CEUS) has been suggested as an alternative modality to fill this gap 8 . It is a novel imaging modality that uses intravenous ultrasound contrast agent (UCA) for objective quantification of bowel wall perfusion 9 .…”

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confidence: 99%

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Diagnostic Value of Quantitative Contrast‐Enhanced Ultrasound in Comparison to Endoscopy in Children With Crohn's Disease

Ponorac

Dahmane

Urlep

et al. 2022

J of Ultrasound Medicine

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Objective Quantitative contrast‐enhanced US (CEUS) provides objective evaluation of bowel wall perfusion and has been reported as a useful method for evaluating Crohn's disease (CD) activity in children. We tested its' diagnostic accuracy in comparison to endoscopy and evaluated its' usefulness in comparison to Pediatric Crohn's Disease Activity Index (PCDAI) and fecal Calprotectin (FC). Materials and methods Children with CD and thickened bowel wall on abdominal US were prospectively enrolled. Disease activity was evaluated with quantitative CEUS, PCDAI and FC and compared to a simple endoscopic score for Crohn's disease (SES‐CD). Spearman's correlation and Cohen's kappa statistic between the SES‐CD and other disease activity measures were performed and diagnostic accuracies calculated. Results 36 children 3.5–18 years old (mean age 14 years) were included. The quantitative CEUS had 78.57% sensitivity (95%CI 0.59–0.92), 100% specificity (95%CI 0.63–1.0) and 83.33% diagnostic accuracy (95% CI 0.67–0.94). The concordance remission agreement with endoscopy was substantial for quantitative CEUS and PCDAI (quantitative CEUS: κ = 0.62; 95% CI 0.363–0.877; PCDAI: κ = 0.615; 95% CI 0.311–0.920), but only fair for FC (κ = 0.389; 95% CI 0.006–0.783). Correlation between all measures and endoscopy was moderate and statistically significant (quantitative CEUS: rs = 0.535, PCDAI: rs = 0.543, FC: rs = 0.497). Conclusions Quantitative CEUS has a potential of becoming a complementary method for evaluation of CD activity in children due to its' high specificity in comparison to endoscopy. Lower sensitivity makes it deficient as a single measure and further management should be guided by PCDAI and FC results as well.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Diagnostic Value of Quantitative Contrast‐Enhanced Ultrasound in Comparison to Endoscopy in Children With Crohn's Disease

Ponorac

Dahmane

Urlep

et al. 2022

J of Ultrasound Medicine

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“…The following are available online at https://www.mdpi.com/article/ 10.3390/diagnostics11101926/s1, Figure S1: Diagnostic odds ratio (DOR) of MRI and US across all studies, Table S1: Search strategy that used in the systematic review, Table S2: Search strategy that used in the systematic review, Table S3: QUADAS-2 summary of risk and applicability (tabular format). References [53][54][55][56][57] are cited in the Supplementary Materials.…”

Section: Supplementary Materialsmentioning

confidence: 99%

Diagnostic Accuracy of Non-Invasive Imaging for Detection of Colonic Inflammation in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

et al. 2021

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Endoscopy is the gold standard for objective assessment of colonic disease activity in inflammatory bowel disease (IBD). Non-invasive colonic imaging using bowel ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) may have a role in quantifying colonic disease activity. We reviewed the diagnostic accuracy of these modalities for assessment of endoscopically or histopathologically defined colonic disease activity in IBD. We searched Embase, MEDLINE, and the Web of Science from inception to 20 September 2021. QUADAS-2 was used to evaluate the studies’ quality. A meta-analysis was performed using a bivariate model approach separately for MRI and US studies only, and summary receiver operating characteristic (ROC) curves were obtained. CT studies were excluded due to the absence of diagnostic test data. Thirty-seven studies were included. The mean sensitivity and specificity for MRI studies was 0.75 and 0.91, respectively, while for US studies it was 0.82 and 0.90, respectively. The area under the ROC curves (AUC) was 0.88 (95% CI, 0.82 to 0.93) for MRI, and 0.90 (95% CI, 0.75 to 1.00) for US. Both MRI and US show high diagnostic accuracy in the assessment of colonic disease activity in IBD patients.

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Contrast-enhanced ultrasound: a comprehensive review of safety in children

et al. 2021

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Contrast-enhanced ultrasonography in the evaluation of Crohn disease activity in children: comparison with histopathology

Cited by 8 publications

References 32 publications

Diagnostic Value of Quantitative Contrast‐Enhanced Ultrasound in Comparison to Endoscopy in Children With Crohn's Disease

Diagnostic Value of Quantitative Contrast‐Enhanced Ultrasound in Comparison to Endoscopy in Children With Crohn's Disease

Diagnostic Accuracy of Non-Invasive Imaging for Detection of Colonic Inflammation in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Contrast-enhanced ultrasound: a comprehensive review of safety in children

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