Impact of high-resolution transabdominal ultrasound in the diagnosis of complications of Crohn's disease

Abstract

High-resolution transabdominal ultrasound done by experienced examiners has an excellent diagnostic accuracy in the diagnosis of complications in patients with Crohn's disease. Thus, it can be recommended as one of the primary investigative procedures for evaluation of Crohn's disease.

Small intestine contrast ultrasonography (SICUS) for the detection of small bowel complications in crohnʼs disease: A prospective comparative study versus intraoperative findings

“…39,40 MRI is a noninvasive, radiationsparing tool but its diagnostic accuracy in detecting SB strictures has not been assessed since no study has compared MRI findings with surgery, except for a promising report referring only to five patients. 36 Despite diagnosis with TUS of CD SB strictures being the object of several reports, 8,9,10,30,[41][42][43] a single study 8 used as reference standard only the surgical pathological findings, showing an excellent sensitivity (100%) and specificity (91%) in the detection of at least one stricture in patients submitted to surgery for obstructive symptoms. The present study confirms that TUS has a high sensitivity (87%) and specificity (100%) in the assessment of the presence of at least one stricture in patients with obstructive symptoms (data not shown), but in addition it shows that SICUS has a higher diagnostic accuracy than TUS to detect: 1) the presence of more than two strictures; 2) those located in the proximal tract of SB; 3) extension of strictures, independently from the presence of prestenotic dilatation and of obstructive symptoms.…”

Bowel Ultrasonography in the Management of Crohnʼs Disease. A Review with Recommendations of an International Panel of Experts

“…10,27,28 Ten studies including a total of 1011 patients with established CD were identified. 10,11,[16][17][18][27][28][29][30][31] Two studies were performed in pediatric populations. 16,30 Eight studies used surgical specimens as reference standard.…”

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

“…The highest values were registered for the detection of abscesses (sensitivity 90-100%, specificity 92-99%, PPV 90% and NPV 99% [49,58]. Therefore, US plays a pivotal role in the detection of abscesses, even though it can produce false positive results [57].…”

“…It is well known that intestinal US has high sensitivity and specificity both for the primary diagnosis of CD [45][46][47][48], and for detecting complications such as stenosis, fistulas and abscesses [25,45,49]. The global sensitivity of intestinal US for the primary diagnosis of CD has been assessed within many meta-analyses, showing a good diagnostic accuracy.…”

“…Intestinal US can also detect the complications of CD: stenosis, fistulas and abscesses, showing good diagnostic accuracy (sensitivity and specificity of 79-100% and 90-98% for stenosis, and 71-87% and 90-96% for fistulas [49,[57][58][59][60]). The highest values were registered for the detection of abscesses (sensitivity 90-100%, specificity 92-99%, PPV 90% and NPV 99% [49,58].…”