Crohn's Disease Activity Evaluation by Transabdominal Ultrasonography: Correlation with Double‐Balloon Endoscopy

Abstract

Objectives-Transabdominal ultrasonography (US) has been reported as a useful tool for evaluating Crohn's disease (CD) activity. Endoscopic findings and Crohn's disease activity index (CDAI) are currently considered the gold standard for assessing CD activity. We assessed the correlation between US and double-balloon endoscopy (DBE), and CDAI for evaluating CD activity.Methods-We analyzed patients with CD undergoing US and DBE within 10 days between the procedures. The intestine was divided into four segments and analyzed by the US scoring system (US-CD) and the simple endoscopic score for Crohn's disease (SES-CD). CDAI was compared with US-CD and SES-CD. Spearman's rank correlation coefficient was used for statistical analysis.Results-Twenty-five patients with CD (11 women, 14 men; mean age 35.4 ± 14.9 years, range 16-65 years) were enrolled. Twenty-four patients received antitumor necrosis factor inhibitor therapy. CDAI was 128.1 (range 36-227). A significant moderate correlation was found between the US-CD and SES-CD in all segments (ρ = .64, P < .01). The US-CD showed a strong correlation with CDAI (ρ = .78, P < .01), whereas the SES-CD showed a moderate correlation (ρ = .55, P < .05).Conclusions-US-CD and SES-CD showed a moderate correlation for assessing CD activity. US-CD showed a stronger correlation with CDAI than SES-CD, suggesting that US could more accurately evaluate the disease activity.

Usefulness of Intestinal Ultrasound to Detect Small Intestinal Stenosis in Patients With Crohn's Disease

“…In this study, it was revealed that IUS had high diagnostic power for detecting small intestinal strictures, and IUS was useful for screening of small intestinal [15][16][17][18][19][20][21][22][23] The findings of our study would be useful in monitoring small intestinal lesions by IUS in the clinical practice of CD.…”

“…In this study, it was revealed that IUS had high diagnostic power for detecting small intestinal strictures, and IUS was useful for screening of small intestinal lesions in patients with CD. Although IUS has been reported to be useful for diagnosis, understanding of disease activity, and detection of fistula, abscesses, and stenoses in patients with CD, it is not yet clear what IUS findings and how to combine these findings for diagnosing small bowel stenosis, and what kind of patient characteristics made the accuracy of IUS higher 15–23 . The findings of our study would be useful in monitoring small intestinal lesions by IUS in the clinical practice of CD.…”

Characteristics and usefulness of transabdominal ultrasonography in immune-mediated colitis

“…US has been found useful in CD, UC, and graft-versus-host disease enterocolitis, and its findings correlated with those of endoscopy. [36][37][38][39][40][41][42][43][44][45] To the best of our knowledge, there has been only 1 case report in which intestinal US was used in IMC. 48 Therefore, our study analyzed the features of US findings in IMC, as well as their correlation with endoscopic findings, CTCAE grade, and CRP.…”

“…1). 37 Doppler study was performed using a 7.5-MHz linear probe, with color gain adjusted until the disappearance of noise to maximize the sensitivity. The color Doppler frequency was set from 3.3 to 4.5 MHz, with a pulse repetition frequency from 4.7 to 10.1 cm/sec, which was adjusted according to the lesion depth.…”

“…[32][33][34][35] In addition, the usefulness of US in diseases of the gastrointestinal tract, such as UC and Crohn' s disease (CD), has been reported recently. [36][37][38][39][40][41][42][43][44][45] With an increase in the indications for ICIs, the incidence of IMC may also increase, and modalities allowing for evaluation of the disease condition through less invasive methods will be needed. Therefore, our study aimed to elucidate the features of US findings in IMC and determine the usefulness of US in IMC.…”