Transperineal Perineal Ultrasound Versus Magnetic Resonance Imaging In the Assessment of Perianal Crohnʼs Disease

Maconi, Giovanni; Tonolini, Massimo; Monteleone, M.; Bezzio, Cristina; Furfaro, Federica; Villa, Chiara; Campari, Alessando; Dell’Era, Alessandra; Sampietro, Gianluca; Ardizzone, Sandro; Franchis, Roberto de

doi:10.1097/01.mib.0000436274.95722.e5

Cited by 55 publications

(51 citation statements)

References 28 publications

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“…Images should be documented using the corresponding system for ERUS. PNUS is more flexible than ERUS, particularly when oblique orientated trans-sphincteric fistulas are to be examined [117,118,[120][121][122][123]. Considering that perianal fistulas and/or abscesses have been found in about 10% of newly diagnosed CD pediatric patients, an immediately available and noninvasive diagnostic tool such as PNUS would be of great benefit for further management and follow-up of affected children (FIGURE 6) [124].…”

Section: Other Sonographic Techniquesmentioning

confidence: 99%

Particularities of Crohn’s disease in pediatric patients: current status and perspectives regarding imaging modalities

Schreiber-Dietrich

Chiorean

Cui

et al. 2015

Expert Review of Gastroenterology & Hepatology

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A consensus on the best imaging modality evaluating inflammatory bowel disease in the pediatric population is lacking and it is often unclear which modality to choose in specific clinical circumstances. Children with inflammatory bowel disease are exposed to ionizing radiation from multiple imaging studies performed at initial diagnosis, throughout treatment and during the follow-up period. This paper discusses the value of different imaging techniques in pediatric patients with inflammatory bowel disease and gives a review of the literature. In addition, particular features of inflammatory bowel disease in children including the predilection of affected segments in the gastrointestinal tract are highlighted. Based on current literature knowledge, we encourage an integrative approach to the interpretation of clinical and imaging data for diagnosis and follow-up in daily clinical settings.

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Section: Other Sonographic Techniquesmentioning

confidence: 99%

Particularities of Crohn’s disease in pediatric patients: current status and perspectives regarding imaging modalities

Schreiber-Dietrich

Chiorean

Cui

et al. 2015

Expert Review of Gastroenterology & Hepatology

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show abstract

“…Studies published by Wedemeyer et al [27] and Maconi et al [28,31] showed that TPUS has a high sensitivity and specificity in detecting perianal disease comparable to those of MRI and EAUS. A study by Rasul et al [32] showed that TPUS can be used to follow perianal fistulas in Crohn's disease patients, concerning therapeutic response.…”

Section: Major Applications In Gastroenterologymentioning

confidence: 92%

Current applications of transperineal ultrasound in gastroenterology

Albuquerque¹,

Pereira²

2016

WJR

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Transperineal ultrasound is an inexpensive, safe and painless technique that dynamically and noninvasively evaluates the anorectal area. It has multiple indications, mainly in urology, gynaecology, surgery and gastroenterology, with increased use in the last decade. It is performed with conventional probes, positioned directly above the anus, and may capture images of the anal canal, rectum, puborectalis muscle (posterior compartment), vagina, uterus, (central compartment), urethra and urinary bladder (anterior compartment). Evacuatory disorders and pelvic floor dysfunction, like rectoceles, enteroceles, rectoanal intussusception, pelvic floor dyssynergy can be diagnosed using this technique. It makes a dynamic evaluation of the interaction between pelvic viscera and pelvic floor musculature, with images obtained at rest, straining and sustained squeezing. This technique is an accurate examination for detecting, classifying and following of perianal inflammatory disease. It can also be used to sonographically guide drainage of deep pelvic abscesses, mainly in patients who cannot undergo conventional drainage. Transperineal ultrasound correctly evaluates sphincters in patients with fecal incontinence, postpartum and also following surgical repair of obstetric tears. There are also some studies referring to its role in anal stenosis, for the measurement of the anal cushions in haemorrhoids and in chronic anal pain. structures interaction during defecation stimulation manoeuvres, as well as the identification, classification, and follow-up in inflammatory perianal disease, and it can also identify sphincter injury in fecal incontinence. In this review the technique is described and the current evidence that supports its use in several areas is also discussed.Albuquerque A, Pereira E. Current applications of transperineal ultrasound in gastroenterology.

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“…Its availability and cost-effectiveness enable perianal ultrasound to monitor real-time recovery of fistulas, thus more expensive MRI might be avoided. Maconi et al[45] showed that the sensitivity of TPUS is relatively poor in the identification of extrasphincteric and suprasphincteric fistulas (55.6% and 50%), but it demonstrated an excellent sensitivity and PPV in the recognition of anovaginal and transsphincteric fistulas (sensitivity: 100% and 90%; PPV: 99.4% and 100%). No special preparation and instrumentation is required, and it can be easily mastered, thus perianal ultrasound might be well applied in gastroenterology and proctology; it can be a fast diagnostic tool as well, especially in urgent cases[17].…”

Section: Inflammatory Bowel Diseasementioning

confidence: 99%

Role of ultrasound in colorectal diseases

Bor¹,

Fábián²,

Szepes³

2016

WJG

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Ultrasound is an undervalued non-invasive examination in the diagnosis of colonic diseases. It has been replaced by the considerably more expensive magnetic resonance imaging and computed tomography, despite the fact that, as first examination, it can usefully supplement the diagnostic process. Transabdominal ultrasound can provide quick information about bowel status and help in the choice of adequate further examinations and treatment. Ultrasonography, as a screening imaging modality in asymptomatic patients can identify several colonic diseases such as diverticulosis, inflammatory bowel disease or cancer. In addition, it is widely available, cheap, non-invasive technique without the use of ionizing radiation, therefore it is safe to use in childhood or during pregnancy, and can be repeated at any time. New ultrasound techniques such as elastography, contrast enhanced and Doppler ultrasound, mini-probes rectal and transperineal ultrasonography have broadened the indication. It gives an overview of the methodology of various ultrasound examinations, presents the morphology of normal bowel wall and the typical changes in different colonic diseases. We will pay particular attention to rectal and transperineal ultrasound because of their outstanding significance in the diagnosis of rectal and perineal disorders. This article seeks to overview the diagnostic impact and correct indications of bowel ultrasound.

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Transperineal Perineal Ultrasound Versus Magnetic Resonance Imaging In the Assessment of Perianal Crohnʼs Disease

Abstract: TPUS is a simple and accurate diagnostic method for classifying perianal fistulae in CD and could be used for the preliminary assessment and follow-up of perianal CD.

Cited by 55 publications

References 28 publications

Particularities of Crohn’s disease in pediatric patients: current status and perspectives regarding imaging modalities

Particularities of Crohn’s disease in pediatric patients: current status and perspectives regarding imaging modalities

Current applications of transperineal ultrasound in gastroenterology

Role of ultrasound in colorectal diseases

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