Contrast-enhanced ultrasonography: Usefulness in the assessment of postoperative recurrence of Crohn's disease

Paredes, José María Rubio; Ripollés, Tomás; Cortés, Xavier; Moreno, N. Fernández; Martínez, María Jesús; Bustamante-Balén, Marco; Delgado, Fructuoso; Moreno-Osset, E

doi:10.1016/j.crohns.2012.03.017

Cited by 105 publications

(71 citation statements)

References 35 publications

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“…Another study also showed that the area under the time-intensity curve obtained after microbubbles injection was the only parameter to discriminate between responders and nonresponders among CD patients during pharmacological treatment (p \ 0.05) [72]. Recently, it was demonstrated that CEUS showed high sensitivity, specificity and accuracy (97, 91, 96%, respectively) for the early detection of endoscopic recurrence after intestinal resection in CD patients, with the simple combination of parietal thickness [5 mm and contrast enhancement [46% [73].…”

Section: Ceusmentioning

confidence: 99%

SICUS and CEUS imaging in Crohn’s disease: an update

et al. 2017

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Endoscopy remains the main technique in the diagnosis and treatment of Crohn's disease (CD); nevertheless, the recent development of innovative and non-invasive imaging techniques has led to a new tool in the exploration of small bowel in CD patients. This paper reviews the available data on ultrasound imaging used for the evaluation of CD, highlighting the role of small intestine contrast-enhanced ultrasonography with the use of oral and intravenous contrast agents.Keywords Crohn's disease Á Contrast-enhanced ultrasound Á Small intestine contrast ultrasonography Sommario Nell'iter diagnostico e terapeutico della malattia di Crohn l'endoscopia rappresenta la principale metodica strumentale. Tuttavia, la recente introduzione di tecniche di imaging innovative e non invasive ha implementato lo studio dell'intestino nelle malattie infiammatorie croniche intestinali. La seguente revisione raccoglie i dati disponibili in letteratura relativi all'utilizzo dell'ecografia con mezzo di contrasto, sia orale (SICUS) sia endovenoso (CEUS), nella valutazione dei pazienti affetti da malattia di Crohn.

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Section: Ceusmentioning

confidence: 99%

SICUS and CEUS imaging in Crohn’s disease: an update

et al. 2017

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“…There are yet few studies concerning this subject, but the results are promising. Biological treatment with anti TNF-α agents was associated with a significant reduction of the intestinal wall diameter and improvement of the transmural vascularization in 50% of the patients [39,69,70]. All US parameters were improved in patients in remission who also had a significant HBI decrease at 3 months after anti TNF-α therapy initiation, showing a good correlation between US markers and clinical signs and symptoms [40].…”

Section: Monitoringmentioning

confidence: 71%

“…At the moment, endoscopy is the gold standard tool in this situation, but lately, US has provided significant credit, with a sensitivity of 89.7% for the detection of recurrent postoperative disease which can be increased by CEUS to 98% [69].…”

Section: Monitoringmentioning

confidence: 99%

The importance of intestinal ultrasound and elastographic techniques in inflammatory bowel diseases

Marin

Tribus

Fierbinţeanu-Braticevici

2018

Med Ultrason

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Inflammatory bowel diseases have an important impact upon the economic and social status due to their increasing incidence and prevalence, often affecting young people. At the moment, the therapeutic goal goes beyond the improvement of symptoms and laboratory parameters, being represented by endoscopic mucosal healing, changing the disease’s natural history. Even though endoscopy is the gold standard for the assessment of mucosal healing, it is an invasive maneuver and it lacks good repeatability. These patients require frequent evaluation; therefore, interest for noninvasive techniques has risen.As a consequence, the importance of intestinal ultrasound has increased lately and recent studies support its use to assess the degree of inflammation, to differentiate between remission and relapse, to monitor therapy response and guide treatment, to evaluate prognosis, and to diagnose complications. Another promising noninvasive imagistic technique is elastography which has gained interest because of its capacity to discriminate between inflammatory and fibrotic tissue, taking into account the different therapeutic options for the fibrotic strictures compared to inflammatory processes. This review summarizes the actual recommendations regarding the use of intestinal ultrasound and elastographic techniques for the diagnosis and monitoring of inflammatory bowel diseases.

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“…The sensitivity and specificity for detecting ileal disease was higher compared to colonic disease (Table 4). Both cases (2/10) missed on US were mild endoscopically, possibly not yet exhibiting cross-sectional disease activity [29]. Regardless of imaging modality, mild disease is difficult to detect, given the absence of transmural involvement, as early disease involves the mucosa and this is also reflected here, as there were 2 false negatives versus only 1 false positive (Table 3).…”

Section: Discussionmentioning

confidence: 87%

Point of Care Ultrasound Accurately Distinguishes Inflammatory from Non Inflammatory Disease in Patients Presenting with Abdominal Pain and Diarrhea

Al-Farhan¹,

Al-Darmaki²,

Shim³

et al. 2017

Gastroenterology

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Background. Approaches to distinguish inflammatory bowel disease (IBD) from noninflammatory disease that are noninvasive, accurate, and readily available are desirable. Such approaches may decrease time to diagnosis and better utilize limited endoscopic resources. The aim of this study was to evaluate the diagnostic accuracy for gastroenterologist performed point of care ultrasound (POCUS) in the detection of luminal inflammation relative to gold standard ileocolonoscopy. Methods. A prospective, single-center study was conducted on convenience sample of patients presenting with symptoms of diarrhea and/or abdominal pain. Patients were offered POCUS prior to having ileocolonoscopy. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with 95% confidence intervals (CI), as well as likelihood ratios, were calculated. Results. Fifty-eight patients were included in this study. The overall sensitivity, specificity, PPV, and NPV were 80%, 97.8%, 88.9%, and 95.7%, respectively, with positive and negative likelihood ratios (LR) of 36.8 and 0.20. Conclusion. POCUS can accurately be performed at the bedside to detect transmural inflammation of the intestine. This noninvasive approach may serve to expedite diagnosis, improve allocation of endoscopic resources, and facilitate initiation of appropriate medical therapy.

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Contrast-enhanced ultrasonography: Usefulness in the assessment of postoperative recurrence of Crohn's disease

Abstract: CEUS shows excellent sensitivity and specificity for the diagnosis of postoperative recurrence in CD and can also detect severe recurrences.

Cited by 105 publications

References 35 publications

SICUS and CEUS imaging in Crohn’s disease: an update

SICUS and CEUS imaging in Crohn’s disease: an update

The importance of intestinal ultrasound and elastographic techniques in inflammatory bowel diseases

Point of Care Ultrasound Accurately Distinguishes Inflammatory from Non Inflammatory Disease in Patients Presenting with Abdominal Pain and Diarrhea

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