Sonographic evaluation of inflammatory bowel disease: a prospective, blinded, comparative study

Abstract

Increased BWT has good positive predictive value for moderate/severe disease in the colon proximal to the rectum (>3 mm), and terminal ileum (>2.5 mm). BWT below this cannot exclude moderate/severe mucosal lesions.

Pediatric Small Bowel Crohn Disease: Correlation of US and MR Enterography

“…A single bowel wall thickness of 2.5-3 mm or more is considered abnormal and specific for diagnosis of Crohn disease in patients with suspected inflammatory bowel disease (11). Bowel wall thickening may be concentric or eccentric, and the echogenic submucosal layer is often the thickest portion of the bowel wall (Figs 2, 3).…”

“…When mesenteric venous thrombosis is noted, the liver should be carefully evaluated for abscesses (24). Spectral Doppler US has also been used to assess the mesenteric vasculature in patients with Crohn disease, although some researchers have concluded that spectral Doppler US findings do not reliably correlate with disease activity (11,25).…”

“…More recently, several authors have suggested that ultrasonography (US) can be used for screening and follow-up of small bowel Crohn disease in children (6)(7)(8)(9)(10)(11). Technologic advances in US have allowed improved visualization of the small bowel and mesentery, especially in the pediatric population.…”

“…Technologic advances in US have allowed improved visualization of the small bowel and mesentery, especially in the pediatric population. One pediatric study ing one or more high-frequency linear transducers (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), convex transducers with lower frequencies may be useful for visualizing bowel loops located deep within the abdomen or pelvis and for examining obese children. Graded compression of the anterior abdominal wall with the US transducer and manual posterior compression with the nonscanning hand can be used to displace or efface normal overlying air and fluid-filled bowel loops and bring abnormal bowel segments closer to the transducer for improved image quality (10,14).…”

Imaging of the small bowel: Crohn’s disease in paediatric patients

“…Extra-mural findings include changes involving the surrounding mesentery, that appears thickened and hyperechoic and generally shows enlarged mesenteric lymph-nodes ( Figure 4) [30,36] . Bowel US and ileocolonoscopy with histology have demonstrated an overall sensitivity of 74 and 88% and a specificity of 78 and 93%, respectively, in the detection of SB CD lesions [35,37] . The sensitivity of US in the detection of SB lesions is greater for those of the terminal ileum (approximately 90%-95%) than for those of the proximal SB (75%) [38] .…”