Sonographie in der Diagnostik der Ileitis terminalis Crohn

Wellmann, W.; Gebel, M; Freise, Julia; Grote, R.

doi:10.1055/s-2008-1056694

Cited by 19 publications

(12 citation statements)

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“…With regard to the detection of bowel abnormalities, the present study confirms the sonomorphology de scribed by others [2,4,6,13,[21][22][23][24][25], In particular, target signs, thickening of the terminal ileum ( fig. 1) and bowel loop conglomerates were seen.…”

Section: Discussionsupporting

confidence: 76%

“…As described, fistulae could be followed but this was only true with enterocutaneous fistulae visible from outside [6]. However, the incidence of abnormal findings was much lower than previously reported by others [1] and resembled more that described by Wellmann et al [2]. This may be due to the fact that the first study [1] basically included inpa tients who are more likely to have more active disease while the second investigation [2], like ours, dealt with a higher percentage of patients in remission.…”

Section: Discussioncontrasting

confidence: 39%

“…A sen sitivity of 84% and a specificity of 91% have been reported [1], largely based on the presence of a patholog ical 'target sign'. This has been questioned, however [2], In addition, US has been shown to be helpful in the assessment of acute abdominal complaints related to the intestinal tract [3][4][5], It has been described in casuistic form that intestinal complications such as fistulae, ab scesses, and bowel conglomerates can be detected [6]. Thus, it might be possible to add US to the known meth ods to assess activity in CD.…”

mentioning

confidence: 99%

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Detection of Extraintestinal and Intestinal Abnormalities in Inflammatory Bowel Disease by Ultrasound

Schölmerich¹,

Braun²,

Volk³

et al. 1987

Dig Surg

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Abdominal ultrasound (US) can detect extraintestinal and intestinal manifestations and complications of Crohn’s disease. However, the clinical value of routine examination of all patients with inflammatory bowel disease is not known. A total of 100 patients (70% outpatients) with inflammatory bowel disease – 74 Crohn’s disease (CD) and 26 ulcerative colitis (UC) – was studied by US without knowledge of clinical or laboratory data except the diagnosis of inflammatory bowel disease. 39% of the patients with CD showed intestinal abnormalities (target sign: 18%, bowel conglomerates 5%, bowel wall diameter > 5 mm: 20%, prestenotic dilatation: 1%), while 35% of patients with UC had such abnormalities (19% target sign and 27% increased bowel wall diameter). Gallstones were found in 12% of patients with CD and 4% of those with UC. Cholecystectomy had been performed in 7 and 4%, respectively. Renal stones were found in 4 and 8%, liver abnormalities in 19% of both patient groups. Overall, in 30 and 27% at least one extraintestinal abnormality was seen. No clear correlation of disease activity with the occurrence of intestinal or extraintestinal findings was found in CD while bowel abnormalities were more likely to be detected in patients with active UC. None of the laboratory parameters assessed predicted the finding of gallstones, renal stones or liver abnormalities. Renal stones occurred more often in patients with ileal resection and longer duration of disease. US was found to be useful in the routine investigation of patients with inflammatory bowel disease since it detects a considerable number of extraintestinal complications. In addition, it can demonstrate intestinal abnormalities and complications and might be an additional noninvasive method to assess disease activity in UC.

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Section: Discussionsupporting

confidence: 76%

Section: Discussioncontrasting

confidence: 39%

mentioning

confidence: 99%

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Detection of Extraintestinal and Intestinal Abnormalities in Inflammatory Bowel Disease by Ultrasound

Schölmerich¹,

Braun²,

Volk³

et al. 1987

Dig Surg

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show abstract

“…[Holt et al 1979, Wellmann et al 1980 Ältere Arbeiten der Angiographie [Bousen et al 1966, Lunderquist 1967 [Sonnenberg et al 1982].…”

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Prospektiver Vergleich von Power-Dopplersonographie und Ileokoloskopie in der Aktivitätsbewertung bei Patienten mit Morbus Crohn

Neye¹

2015

Z Gastroenterol

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“…Thickness and structure of the intestinal wall have been studied by B-mode sonography [1][2][3][4][5][6][7]. Bowel wall thickening in patients with Crohn's disease can be caused by inflammation or fibrosis, therefore conventional ultrasound does not permit differentiation between active and inactive disease [8].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Criteria for the Activity of Crohn’s Disease by Power Doppler Sonography

Neye

Voderholzer

Rickes

et al. 2004

Dig Dis

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Background/Aim: In recent years, power Doppler sonography has been proposed as a method to assess disease activity in patients with Crohn’s disease. The aim of this prospective study was to evaluate diagnostic criteria for power Doppler sonography by blinded comparison with ileocolonoscopy. Methods: Twenty-two patients with confirmed Crohn’s disease were prospectively investigated with B-mode and power Doppler sonography (HDI 5000, Philips Ultrasound) as well as ileocolonoscopy. Sonography was performed within 3 days before endoscopy. All procedures were performed by experienced examiners who were blinded to the clinical data and other results. Defined ultrasound parameters (bowel wall thickness, vascularization pattern) were used to determine a sonographic score of the activity. The degree of activity was scored from 1 (none) to 4 (high) by both ultrasound and ileocolonoscopy (pattern, extent of typical lesions). For each patient all segments of the colon and the terminal ileum were evaluated by both ultrasound and endoscopy. The weighted ĸ test was used (StatXact software) for statistical analysis. Results: In total, 126 bowel segments were evaluated by both ultrasound and endoscopy. The study showed a high concordance of power Doppler sonography and ileocolonoscopy (weighted ĸ by region: sigmoid colon: 0.81; transverse colon: 0.78; ascending colon: 0.75; cecum: 0.84; terminal ileum: 0.82). Highest concordance was found in the descending colon (weighted ĸ: 0.91; 95% CI: 0.83–0.98). Conclusions: Combination of B-mode and power Doppler sonography has a high accuracy in the determination of disease activity in Crohn’s disease when compared to ileocolonoscopy. The diagnostic criteria established in this study can be useful for the evaluation of inflammatory bowel diseases by ultrasound.

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Sonographie in der Diagnostik der Ileitis terminalis Crohn

Cited by 19 publications

References 0 publications

Detection of Extraintestinal and Intestinal Abnormalities in Inflammatory Bowel Disease by Ultrasound

Detection of Extraintestinal and Intestinal Abnormalities in Inflammatory Bowel Disease by Ultrasound

Prospektiver Vergleich von Power-Dopplersonographie und Ileokoloskopie in der Aktivitätsbewertung bei Patienten mit Morbus Crohn

Evaluation of Criteria for the Activity of Crohn’s Disease by Power Doppler Sonography

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