Small Intestine Contrast Ultrasonography in Pediatric Crohn's Disease

Pallotta, Nadia; Civitelli, Fortunata; Nardo, Giovanni Di; Vincoli, Giuseppina; Aloi, Marina; Viola, Franca; Capocaccia, P; Corazziari, Enrico; Cucchiara, Salvatore

doi:10.1016/j.jpeds.2013.03.056

Cited by 64 publications

(49 citation statements)

References 34 publications

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“…In children, the sensitivity of US ranges from 48% to 88% with a specificity range of 57% to 100% [14][15][16][17][18][19]. The use of US for evaluation of Crohn disease started in Europe and is now being introduced in the United States [4][5][6][7][8][9][10]20].…”

Section: Discussionmentioning

confidence: 99%

“…Many studies used endoscopy and/or biopsy as the reference standard [14][15][16][17][18][19]21]. In a study by Ziech et al [14], US was performed on the same day as MRE and colonography; however, sensitivity and specificity of US were compared to colonoscopy, which was performed on average 7.5 days (1-40 days) from the US study.…”

Section: Discussionmentioning

confidence: 99%

“…Likewise, in many other studies, US was not performed at the time of endoscopy and therefore the pathology could have changed by the time US was performed [15][16][17][18][19]. For this reason, we chose MRE performed immediately before or after US as the reference standard.…”

Section: Discussionmentioning

confidence: 99%

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Can ultrasound be used as the primary imaging in children with suspected Crohn disease?

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Can ultrasound be used as the primary imaging in children with suspected Crohn disease?

et al. 2017

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“…Ultrasonography of the pediatric gastrointestinal tract may be identified, associated with prestenotic dilatation, hyperperistalsis, and fecalization [9] . Small intestine contrast ultrasonongraphy, using oral administration of iso-osmolar PEG, improves evaluation of the small bowel in patients with Crohn disease [79] . Contrast enhanced ultrasound using IV administration of microbubble contrast shows promising results; the pattern of mural enhancement may aid in assessment of disease activity and/or response to therapy [80] .…”

Section: A B C D E F G Hmentioning

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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“…A metaanalysis showed abdominal ultrasound had a sensitivity of 89.7% and a specificity of 95.6% for diagnosing IBD [23] . One group demonstrated 57% sensitivity in detecting undiagnosed CD among adults [43] and 76% sensitivity among undiagnosed children [44] with transabdominal ultrasound. Addition of enteral contrastdemonstrated improved sensitivity to as high as 94% among adults and 100% among children.…”

Section: Mrementioning

confidence: 99%

Role of imaging in the evaluation of inflammatory bowel disease: How much is too much?

Haas¹,

Rubesova²,

Bass³

2016

WJR

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Inflammatory bowel disease (IBD) is a lifelong condition with waxing and waning disease course that requires reassessment of disease status as well as screening for complications throughout a patient's lifetime. Laboratory testing, endoscopic assessment, and fecal biomarkers are often used in the initial diagnosis and ongoing monitoring of a patient with IBD. Imaging plays an integral role in the diagnosis and evaluation of IBD. Different imaging modalities can be used over the course of a patient's lifetime, from the initial screening and diagnosis of IBD, to determining the extent of intestinal involvement, monitoring for disease activity, and evaluating for complications of uncontrolled IBD. The various imaging modalities available to the provider each have a unique set of risks and benefits when considering cost, radiation exposure, need for anesthesia, and image quality. In this article we review the imaging techniques available for the evaluation of IBD including fluoroscopic small bowel follow-through, computed tomography enterography, magnetic resonance enterography, and transabdominal ultrasound with particular focus on the judicious use of imaging and the risks and benefits of each option. We also review the risks of ionizing radiation, strategies to reduce exposure to ionizing radiation, and current imaging guidelines among pediatric and adult patient with IBD. Core tip: Imaging plays a key role in the diagnosis and lifelong evaluation of a patient with inflammatory bowel disease (IBD). Several imaging modalities are available, each with a unique set of risks and benefits when considering cost, anesthesia risk in the pediatric population, ionizing radiation, image quality, and availability. In this article, we review the imaging techniques

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Small Intestine Contrast Ultrasonography in Pediatric Crohn's Disease

Abstract: The radiation-free technique SICUS is comparable with radiology and more accurate than TUS in assessing small bowel lesions in pediatric CD, mainly in the detection of proximal small bowel disease.

Cited by 64 publications

References 34 publications

Can ultrasound be used as the primary imaging in children with suspected Crohn disease?

Can ultrasound be used as the primary imaging in children with suspected Crohn disease?

Abdominal ultrasonography of the pediatric gastrointestinal tract

Role of imaging in the evaluation of inflammatory bowel disease: How much is too much?

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