Role of Cross-Sectional Imaging in Pediatric Inflammatory Bowel Disease

Grandmougin, Aurélie; D’Amico, Ferdinando; Rémen, Thomas; Danese, Silvio; Bonneton, Marjorie; Galloy, M. A.; Peyrin–Biroulet, Laurent; Laurent, V.

doi:10.1007/s10620-021-07016-z

Cited by 2 publications

(5 citation statements)

References 40 publications

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“…Paediatric patients benefit greatly from IUS. Extensive disease evolution is more frequent in children compared to adults, especially in the small bowel, and this poses a greater threat to their development [52,84]. The pathological findings are similar to those of adults, with BWT remaining the most reliable predictor of disease.…”

Section: Discussionmentioning

confidence: 95%

“…However, these findings are highly non-specific, and their presence alone should not be considered an absolute diagnostic marker [37,40]. Radiological remission in this group has also been suggested to greatly reduce the risk of recurrence or complications [52,105]. Contrast administration in children has been approved by the United States Food and Drug Administration in 2016, but its use in this population remains to be determined [67].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical remission is not necessarily associated with complete cessation of inflammation of bowel segments. In contrast, some symptomatic patients lack CS or imaging proof of disease activity [52]. These situations emphasise the need for patient-tailored evaluation, of which IUS shows great feasibility and good results in all aspects of activity evaluation and treatment monitoring.…”

Section: Prediction Of Disease Evolution and Prognosismentioning

confidence: 99%

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Novelties and Perspectives of Intestinal Ultrasound in the Personalised Management of Patients with Inflammatory Bowel Diseases—A Systematic Review

Mihai,

Gheorghe,

Rezuș

et al. 2024

Diagnostics

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Inflammatory bowel diseases (IBDs) affect over 4.9 million individuals worldwide. Colonoscopy (CS) is the gold-standard technique for diagnosis. The remissive–recurrent pattern of evolution raises the need for non-invasive techniques to monitor disease activity. This review aims to present the advantages of intestinal ultrasound (IUS) in managing IBDs. Our search was conducted on the PubMed, Embase, and Cochrane (CENTRAL) databases, selecting original studies comparing IUS with other imaging and invasive monitoring methods. Our search yielded 8654 results, of which 107 met the inclusion criteria. Increased bowel wall thickness (BWT) and colour Doppler signal (CDS) are discriminative for disease activity. IUS can predict disease outcomes and detect response to treatment or postoperative recurrence. Contrast-enhanced ultrasound (CEUS) and elastography help differentiate fibrotic from inflammatory stenoses. The difficult rectal assessment limits the use of IUS in ulcerative colitis (UC). Transmural healing may develop as a therapeutic target as it is associated with better outcomes. Patients are compliant with this technique, and its results correlate well with CS and other imaging methods. In conclusion, IUS proves to be essential in assessing IBD activity and treatment response, predicting outcomes and detecting complications. CEUS and elastography are researched to improve the diagnostic values of IUS.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Prediction Of Disease Evolution and Prognosismentioning

confidence: 99%

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Novelties and Perspectives of Intestinal Ultrasound in the Personalised Management of Patients with Inflammatory Bowel Diseases—A Systematic Review

Mihai,

Gheorghe,

Rezuș

et al. 2024

Diagnostics

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“…Radiological evaluation is important when assessing transmural involvement in paediatric CD. Magnetic resonance enterography (MRE) serves as a disease quantification tool and is one of the primary modalities that can evaluate transmural lesions and extraintestinal complications of CD 10 . MRE can play a significant role in decision‐making of CD management and is a reliable tool that can be used to monitor treatment responsiveness.…”

Section: Introductionmentioning

confidence: 99%

“…Magnetic resonance enterography (MRE) serves as a disease quantification tool and is one of the primary modalities that can evaluate transmural lesions and extraintestinal complications of CD. 10 MRE can play a significant role in decision-making of CD management and is a reliable tool that can be used to monitor treatment responsiveness. However, it is unclear whether current studies provide sufficient evidence to draw firm conclusions about the superiority of TH over EH as a treatment goal.…”

Section: Introductionmentioning

confidence: 99%

Transmural healing evaluated by magnetic resonance enterography in paediatric patients with Crohn's disease receiving maintenance treatment with biologics

Choi

Kim

Jeon

et al. 2022

Aliment Pharmacol Ther

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Background:The optimal treatment goal in Crohn's disease (CD) is endoscopic healing (EH). However, transmural healing (TH) facilitated by the development and increasing performance of magnetic resonance enterography (MRE) is emerging as a potential treatment goal.Aims: To assess TH rates after 1 year of treatment by MRE and its relationship with EH in paediatric patients with CD receiving anti-tumour necrosis factor (TNF) agents, and to investigate factors associated with TH after 1 year of treatment.Methods: This multi-centre, prospective, observational study included Korean paediatric patients with luminal CD diagnosed at age < 19 years who were naïve to anti-TNF treatment. They simultaneously underwent ileocolonoscopy and MRE at baseline and after 1 year of treatment with biologics. Results:We included 116 patients. At 1 year, EH and TH were achieved in 59.5% (69/116) and 38.8% (45/116) of the patients, respectively. Both EH and TH was observed in 35.3% (41/116), EH without TH in 24.1% (28/116), TH without EH in 3.4% (4/116), and neither EH nor TH in 37.1% (43/116). Moreover, 59.4% (41/69) of patients who achieved EH at 1 year exhibited TH, and 91.1% (41/45) of patients who achieved TH exhibited EH. Baseline MaRIA score was associated with TH according to a multivariate analysis (OR 0.97, 95% CI 0.95-0.99, p = 0.023). Conclusion:TH is a more stringent goal than EH. Regular follow-up evaluation of transmural status, and efforts to achieve TH, may alter the natural course of CD in the era of treat-to-target.

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Role of Cross-Sectional Imaging in Pediatric Inflammatory Bowel Disease

Cited by 2 publications

References 40 publications

Novelties and Perspectives of Intestinal Ultrasound in the Personalised Management of Patients with Inflammatory Bowel Diseases—A Systematic Review

Novelties and Perspectives of Intestinal Ultrasound in the Personalised Management of Patients with Inflammatory Bowel Diseases—A Systematic Review

Transmural healing evaluated by magnetic resonance enterography in paediatric patients with Crohn's disease receiving maintenance treatment with biologics

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