Magnetic resonance enterography, small-intestine contrast US, and capsule endoscopy to evaluate the small bowel in pediatric Crohn’s disease: a prospective, blinded, comparison study

Aloi, Marina; Nardo, Giovanni Di; Romano, Gaetano; Casciani, Emanuele; Civitelli, Fortunata; Oliva, Salvatore; Viola, Franca; Maccioni, Francesca; Gualdi, Gianfranco; Cucchiara, Salvatore

doi:10.1016/j.gie.2014.07.009

Cited by 59 publications

(74 citation statements)

References 30 publications

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“…To limit the costs related to MRI and its poor availability in some clinical settings, the use of ultrasounds could provide similar information in selected patients. In expert hands, ultrasounds demonstrated good accuracy in evaluating transmural disease activity [26, 27]. Thus, our data should be interpreted as a suggestion to routine evaluation of transmural disease activity, regardless of the chosen method, more than a recommendation to the choice of a specific technique.…”

Section: Discussionmentioning

confidence: 81%

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Laterza

Piscaglia

Minordi

et al. 2018

Dig Dis

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Aim: To evaluate if a single and/or combined (clinical, endoscopic and radiological) assessment could predict clinical outcomes in Crohn’s disease (CD). Methods: We prospectively evaluated 57 CD cases who underwent both a colonoscopy and a CT-enterography (CTE). Harvey-Bradshaw Index (HBi), SES-CD (and/or Rutgeerts score) and the radiological disease activity were defined to stratify patients according to clinical, endoscopic and radiological disease activity respectively. Hospitalizations, surgery, therapeutic changes and deaths were evaluated up to 36 months (time 1) for 53 patients. Results: CTE and endoscopy agreed in stratifying disease activity in 47% of cases (k = –0.05; p = 0.694), CTE and HBi in 35% (k = 0.09; p = 0.08), endoscopy and HBi in 39% (k = 0.13; p = 0.03). Taken together, CTE, endoscopy and HBi agreed only in 18% of cases (k = 0.01; p = 0.41). Among the 11 cases with mucosal healing, only 3 (27%) showed transmural healing. Patients with endoscopic activity needed significantly more changes of therapy compared to patients with endoscopic remission (p = 0.02). Patients with higher transmural or clinical activity at baseline required significantly more hospitalizations (p < 0.01). Hospitalization rate decreases with an increase in the number of parameters indicating remissions at baseline (p = 0.04). Conclusions: Clinical, endoscopic and radiological assessments offer complementary information and could predict different mid-term outcomes in CD.

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Section: Discussionmentioning

confidence: 81%

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Laterza

Piscaglia

Minordi

et al. 2018

Dig Dis

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“…Overall there was no significant difference among the three imaging modalities for the detection of active small bowel CD. Combining diagnostic imaging improved collective sensitivities, and combining SICUS with the serological marker C-reactive protein increased the specificity for the detection of CD from 89% to 100% in the jejunum, and from 79% to 100% in the distal ileum (p < 0.05) [53] . Preliminary data has suggested a role for power Doppler imaging in enhancing the diagnostic accuracy of conventional US and SICUS.…”

Section: Trans-abdominal Us and Small Intestine Contrastenhanced Usmentioning

confidence: 99%

“…SICUS may be particularly well suited to investigating small bowel CD in children, where routine additional challenges include poorer tolerance to ileocolonoscopy (IC) requiring general anaesthetic, difficulty lying still for a time-consuming MRI, and increased sensitivity to ionising radiation. A recent prospective study by Aloi et al [53] compared MRE, SICUS and video capsule endoscopy in the evaluation of 25 children with suspected or known CD. Overall there was no significant difference among the three imaging modalities for the detection of active small bowel CD.…”

Section: Trans-abdominal Us and Small Intestine Contrastenhanced Usmentioning

confidence: 99%

Diagnostic imaging and radiation exposure in inflammatory bowel disease

Zakeri¹,

Pollok²

2016

WJG

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“…É uma modalidade de exame muito indicada para crianças com a doença, uma vez que a colonoscopia requer anestesia, pode haver dificuldade em permanecer imóvel por uma RNM demorada, e esse perfil de pacientes apresentam um aumento da sensibilidade às radiações ionizantes, presentes na TC e no raio-x. Pesquisas recentes demonstram que a combinação da USG trans-abdominal com marcadores sorológicos e proteína C-reativa aumentou a especificidade para a detecção da doença de Crohn de 89% a 100% no jejuno, e de 79% a 100% no íleo distal (ALOI et al, 2015) Tratamento Os principais objetivos no tratamento da doença de Crohn, tendo em conta o fato de se tratar de uma doença crónica que segue um curso que inclui períodos de exacerbação e remissão, são: melhoria da qualidade da vida; preservação da função intestinal; prevenir e tratar qualquer complicação. Todas as opções de tratamento farmacológico disponíveis são derivadas da hipótese de que, como já dito anteriormente, a doença de Crohn é uma condição resultante da hiperatividade do sistema imunológico, levando a um processo inflamatório crônico da mucosa intestinal.…”

Section: Ultrassonografia Trans-abdominalunclassified

Doença De Crohn

Papacosta¹,

Nunes²,

Pacheco³

et al. 2017

Rev Pat Tocantins

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INTRODUÇÃO: A doença de Crohn é qualificada como uma doença inflamatória intestinal, de caráter crônico, recidivante, transmural e que pode afetar qualquer parte do trato digestivo, desde a boca até o ânus, mas, principalmente, o intestino delgado e o cólon. São de cunho multifatorial, com prevalência e incidência variando de acordo com a genética, meio ambiente, microbiota intestinal e até mesmo um possível agente entérico infeccioso. É uma doença que afeta pessoas de várias idades, sexos e raças, apesar de se verificar maior incidência em jovens do sexo feminino e em regiões urbanas. METODOLOGIA: Trata-se de um artigo de revisão no qual, a partir das palavras “doença de Crohn” e “doença inflamatórias intestinais”, foi realizado busca por periódicos nos bancos de dados: PubMed, Scielo, Portal Periódicos CAPES e Google acadêmico. CONCLUSÃO: A doença de Crohn apresenta uma importante taxa de morbimortalidade no mundo, principalmente em regiões em franca urbanização e industrialização. O diagnóstico é um procedimento extremamente complicado devido a sua clínica inespecífica e pelos vários aspetos em comum com outras patologias. Dessa forma, ainda se faz necessário uma melhor investigação científica na área, com intuito de se desenvolver melhores técnicas diagnosticas e condutas a serem tomadas no seguimento e cura dessa patologia.Palavras-chave: Doença de Crohn, Doença inflamatórias intestinais, Diarreia. ABSTRACT INTRODUCTION: Crohn's disease is described as an inflammatory, chronic, recurrent, transmural inflammatory disease that can affect any part of the digestive tract, from the mouth to the anus, but especially the small intestine and colon. They are multifactorial, with prevalence and incidence varying according to genetics, environment, intestinal microbiota and even a possible infectious enteric agent. It is a disease that affects people of various ages, sexes and races, although there is a greater incidence in young women and in urban areas. METHODOLOGY: This is a review article in which, from the words "Crohn's disease" and "inflammatory bowel disease", a search was made for journals in the databases: PubMed, Scielo, Portal Periódicos CAPES and Google academic. CONCLUSION: Crohn's disease presents an important morbidity and mortality rate in the world, especially in regions where there is rapid urbanization and industrialization. Diagnosis is an extremely complicated procedure due to its nonspecific clinical and various aspects in common with other pathologies. Thus, a better scientific investigation in the area is still necessary, in order to develop better diagnostic techniques and behaviors to be taken in the follow-up and cure of this pathology. Keywords: Crohn's disease, Inflammatory bowel disease, Diarrhea.

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Magnetic resonance enterography, small-intestine contrast US, and capsule endoscopy to evaluate the small bowel in pediatric Crohn’s disease: a prospective, blinded, comparison study

Cited by 59 publications

References 30 publications

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Diagnostic imaging and radiation exposure in inflammatory bowel disease

Doença De Crohn

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