Hydrosonography of the Gastrointestinal Tract

Maconi, Giovanni; Radice, E.; Bareggi, Emilia; Porro, G. Bianchi

doi:10.2214/ajr.08.1979

Cited by 51 publications

(52 citation statements)

References 63 publications

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“…Oral administration of noncarbonated fluid 30 min prior to the examination will reduce air in the bowel [4] . Other promising newer techniques include oral contrast agents, such as isoosmolar polyethylene glycol (PEG), to improve bowel distension, referred to as small-intestine contrast enhanced ultrasound [5] . Intravenous contrast agents are not approved for children but are increasingly utilized off-label, particularly in pediatric patients with IBD [4,6] .…”

Section: Imaging Techniquementioning

confidence: 99%

Abdominal ultrasonography of the pediatric gastrointestinal tract

Gale¹,

Gee²,

Westra³

et al. 2016

WJR

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Ultrasound is an invaluable imaging modality in the evaluation of pediatric gastrointestinal pathology; it can provide real-time evaluation of the bowel without the need for sedation or intravenous contrast. Recent improvements in ultrasound technique can be utilized to improve detection of bowel pathology in children: Higher resolution probes, color Doppler, harmonic and panoramic imaging are excellent tools in this setting. Graded compression and cine clips provide dynamic information and oral and intravenous contrast agents aid in detection of bowel wall pathology. Ultrasound of the bowel in children is typically a targeted exam; common indications include evaluation for appendicitis, pyloric stenosis and intussusception. Bowel abnormalities that are detected prenatally can be evaluated after birth with ultrasound. Likewise, acquired conditions such as bowel hematoma, bowel infections and hernias can be detected with ultrasound. Rare bowel neoplasms, vascular disorders and foreign bodies may first be detected with sonography, as well. At some centers, comprehensive exams of the gastrointestinal tract are performed on children with inflammatory bowel disease and celiac disease to evaluate for disease activity or to confirm the diagnosis. The goal of this article is to review up-to-date imaging techniques, normal sonographic anatomy, and characteristic sonographic features of common and uncommon disorders affecting the gastrointestinal tract in children.

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Section: Imaging Techniquementioning

confidence: 99%

Abdominal ultrasonography of the pediatric gastrointestinal tract

Gale¹,

Gee²,

Westra³

et al. 2016

WJR

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“…One hour before US scanning, 2 L of a highly diluted barium sulfate suspension (VoLumen; E-Z-Em, Lake Success, NY) was administered through a nasogastric tube placed into the stomach to improve small bowel distention and to minimize intraluminal air, according to standard protocols for clinical cross-sectional small-bowel imaging (13)(14)(15). Pigs were premedicated with acetylsalicylic acid (Aspirin; Wedgewood, Swedesboro, NJ) administered either orally (3.5 mg per kilogram of body weight, every 12 hours beginning 24 hours prior to US; n = 12) or intravenously (3.5 mg/kg; 5 minutes prior to intravenous contrast agent injection; n = 11) as previously described (16)(17)(18)(19).…”

Section: Molecular Imaging: Us Of Inflammation In An Ileitis Model Wimentioning

confidence: 99%

Quantitative Assessment of Inflammation in a Porcine Acute Terminal Ileitis Model: US with a Molecularly Targeted Contrast Agent

et al. 2015

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Purpose:To evaluate the feasibility and reproducibility of ultrasonography (US) performed with dual-selectin-targeted contrast agent microbubbles (MBs) for assessment of inflammation in a porcine acute terminal ileitis model, with histologic findings as a reference standard. Materials and Methods:The study had institutional Animal Care and Use Committee approval. Acute terminal ileitis was established in 19 pigs; four pigs served as control pigs. The ileum was imaged with clinical-grade dual P-and E-selectin-targeted MBs (MB Selectin ) at increasing doses (0.5, 1.0, 2.5, 5.0, 10, and 20 3 10 8 MB per kilogram of body weight) and with control nontargeted MBs (MB Control ). For reproducibility testing, examinations were repeated twice after the MB Selectin and MB Control injections. After imaging, scanned ileal segments were analyzed ex vivo both for inflammation grade (by using hematoxylin-eosin staining) and for expression of selectins (by using quantitative immunofluorescence analysis). Statistical analysis was performed by using the t test, intraclass correlation coefficients (ICCs), and Spearman correlation analysis. Results:Imaging signal increased linearly (P , .001) between a dose of 0.5 and a dose of 5.0 3 10 8 MB/kg and plateaued between a dose of 10 and a dose of 20 3 10 8 MB/ kg. Imaging signals were reproducible (ICC = 0.70), and administration of MB Selectin in acute ileitis resulted in a significantly higher (P , .001) imaging signal compared with that in control ileum and MB Control . Ex vivo histologic grades of inflammation correlated well with in vivo US signal (r = 0.79), and expression levels of both P-selectin (37.4% 6 14.7 [standard deviation] of vessels positive; P , .001) and E-selectin (31.2% 6 25.7) in vessels in the bowel wall of segments with ileitis were higher than in control ileum (5.1% 6 3.7 for P-selectin and 4.8% 6 2.3 for E-selectin). Conclusion:Quantitative measurements of inflammation obtained by using dual-selectin-targeted US are reproducible and correlate well with the extent of inflammation at histologic examination in a porcine acute ileitis model as a next step toward clinical translation.q RSNA, 2015

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“…Colon HS was used to determine the segments of the digestive tract affected by the pathological process (ileum, colon), to delineate colon and ileum wall, and to assess haustration and mucosal irregularities [8,9]. HS was performed after previous colon preparation (including 2 enemas a few hours before examination), with the colon filled with fluid and after emptying.…”

Section: Colon Hsmentioning

confidence: 99%

“…Bowel wall thickness > 3 mm was considered pathological and the stratification pattern was classified as follows: visualization of all the layers (stratification is present), blurred stratification with thickening of the submucosa and complete loss of stratification [6][7][8]. The presence of signal during color/power Doppler was considered a sign of disease activity.…”

Section: Colon Hsmentioning

confidence: 99%

Bowel elastography – a pilot study for developing an elastographic scoring system to evaluate disease activity in pediatric Crohn’s disease.

2015

Med Ultrason

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The diagnosis and monitoring of Crohn's disease (CD) represents a diagnosis challenge in which imaging plays an important role. Aim: In the present paper we aim to demonstrate the role of sonoelastography (SE), performed in addition to hydrosonography (HS), in the evaluation of CD in children and to propose a scoring system for the appreciation of disease activity. Material and method: All the patients included into the study were diagnosed with CD and had underwent HS and SE as part of the imaging evaluation. In selected cases magnetic resonance enterography (MRE) was also performed. SE aspects were classified into three types, each corresponding to a specific bowel wall pattern: normal or remission (type A), inflammation (type B) and fibrosis (type C); this classification represents the basis of the scoring system. For the purpose of statistical analysis each evaluated bowel segment became an individual case. Results: Forty eight bowel segments were evaluated by SE: 21 type A, 20 type B and 7 type C. Statistically significant correlations were found between the intestinal wall HS changes, presence of complications, activity markers and the SE score. The HS assessment of the periintestinal area correlated only partially with SE score, while certain SE scores also proved to be predictors for the presence of complications or for increased values of the disease activity markers. Conclusions: SE, along with HS, represents a reliable investigation in the correct diagnosis and monitoring of pediatric patients with CD and the SE scoring system may be introduced as a method for the assessment of disease activity.

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Hydrosonography of the Gastrointestinal Tract

Abstract: The use of a luminal contrast agent in bowel sonography may improve results but should be adopted on a case-by-case basis, according to the clinical context and the experience of the sonologist.

Cited by 51 publications

References 63 publications

Abdominal ultrasonography of the pediatric gastrointestinal tract

Abdominal ultrasonography of the pediatric gastrointestinal tract

Quantitative Assessment of Inflammation in a Porcine Acute Terminal Ileitis Model: US with a Molecularly Targeted Contrast Agent

Bowel elastography – a pilot study for developing an elastographic scoring system to evaluate disease activity in pediatric Crohn’s disease.

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