Ultrasonography as a primary diagnostic tool in patients with inflammatory disease and tumors of the small intestine and large bowel

Bozkurt, T; Richter, Friederike; Lux, G.

doi:10.1002/jcu.1870220204

Cited by 83 publications

(63 citation statements)

References 27 publications

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“…It is impossible to achieve a complete visualization of the small bowel at an ultrasound examination and reproducibility of the findings is problematic. This is due, on one hand, to the above-mentioned gas overlay, but also to the fact that findings by different examiners using different units, together with the difficulties involved with standardization of the data, may lead to divergent interpretations of the ultrasound status [27]. In the present retrospective study, data concerning the length of involved bowel segments were similarly inadequate and had to be excluded from the final evaluation.…”

Section: Discussionmentioning

confidence: 83%

Ultrasound and magnetic resonance imaging in Crohn's disease: a comparison

et al. 2001

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The objective of this retrospective study was to compare MRI of the abdomen with ultrasound of the abdomen and gastrointestinal tract in patients with Crohn's disease. Forty-six patients were included in the study. We analyzed the localization of Crohn's lesions, the number of affected bowel segments, the number of stenoses, and the presence of abscesses, fistulae, and any additional findings. Findings were verified by means of one or more of the following: enteroclysis; surgical findings; and colonoscopy. The results show that MRI is superior to ultrasound in the localization of affected bowel segments (sensitivity: MRI 97.5%; US 76%) and in recognizing fistulae (sensitivity: MRI 87%; US 31%), stenoses (sensitivity: MRI 100%; US 58%) and abscesses (sensitivity: MRI 100%; US 89%). Magnetic resonance imaging of the abdomen should be obtained to clarify discrepant clinical and sonographic findings. In addition, despite its higher cost, MRI of the abdomen is justified in patients in whom Crohn's lesions are known or suspected in anatomic areas proximal to the terminal or neoterminal ileum and in cases with suspicion of fistulae and abscesses.

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Section: Discussionmentioning

confidence: 83%

Ultrasound and magnetic resonance imaging in Crohn's disease: a comparison

et al. 2001

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“…This technique is rarely used; only a few investigators have described the intentional use of percutaneous biopsy of the gastrointestinal tract [4,16]. However, it has been described as a result of a biopsy of an abdominal mass of unknown origin.…”

Section: Discussionmentioning

confidence: 97%

Eosinophilic gastroenteritis: percutaneous biopsy under ultrasound guidance

et al. 1998

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Eosinophilic gastroenteritis (EG) is an unusual disorder that is characterized by diffuse or scattered eosinophilic infiltration of the digestive tract. The diagnosis is based on histology obtained by capsule, endoscopic, laparoscopic, or laparotomy biopsy. The eosinophilic infiltration produces thickening of the small bowel wall that can be observed by using sonography. The appearance produces the pseudokidney sign that can be used to guide biopsy. We report the first case of EG diagnosed by percutaneous biopsy under ultrasound guidance.

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“…The known reliance on expertise and associated steep learning curve [12], together with technical difficulties in obese or ''gassy'' abdomens, have always limited the uptake of SbUS, as has the general reluctance of clinicians to request the examination (which is confirmed in this survey). However, studies investigating the diagnostic accuracy of ultrasound have shown reasonable results with sensitivity ranging between 84% and 90% and specificity between 98% and 100% [13][14][15][16][17][18]. The rapidity and safety of ultrasound, together with the relative accessibility of the terminal ileum in most patients, probably explain the relatively frequent use of this technique by radiologists seeking to exclude disease, particularly in younger patients with a low underlying clinical suspicion of disease.…”

Section: Discussionmentioning

confidence: 99%

Use of small bowel imaging for the diagnosis and staging of Crohn’s disease—a survey of current UK practice

Hafeez¹,

Greenhalgh²,

Rajan³

et al. 2011

BJR

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Objectives: This study used a postal survey to assess the current use of small bowel imaging investigations for Crohn's disease within National Health Service (NHS) radiological practice and to gauge gastroenterological referral patterns. Methods: Similar questionnaires were posted to departments of radiology (n5240) and gastroenterology (n5254) identified, by the databases of the Royal College of Radiologists and British Society of Gastroenterologists. Questionnaires enquired about the use of small bowel imaging in the assessment of Crohn's disease. In particular, questionnaires described clinical scenarios including first diagnosis, disease staging and assessment of suspected extraluminal complications, obstruction and disease flare. The data were stratified according to patient age. Results: 63 (27%) departments of radiology (20 in teaching hospitals and 43 in district general hospitals (DGHs)) and 73 (29%) departments of gastroenterology replied. These departments were in 119 institutions. Of the 63 departments of radiology, 55 (90%) routinely performed barium follow-though (BaFT), 50 (80%) CT, 29 (46%) small bowel ultrasound (SbUS) and 24 (38%) small bowel MRI. BaFT was the most commonly used investigation across all age groups and indications. SbUS was used mostly for patients younger than 40 years of age with low index of clinical suspicion for Crohn's disease (in 44% of radiology departments (28/63)). MRI was most frequently used in patients under 20 years of age for staging new disease (in 27% of radiology departments (17/ 63)) or in whom obstruction was suspected (in 29% of radiology departments (18/63)). CT was preferred for suspected extraluminal complications or obstruction (in 73% (46/ 63) and 46% (29/63) of radiology departments, respectively). Gastroenterological referrals largely concurred with the imaging modalities chosen by radiologists, although gastroenterologists were less likely to request SbUS and MRI. Conclusion: BaFT remains the mainstay investigation for luminal small bowel Crohn's disease, with CT dominating for suspected extraluminal complications. There has been only moderate dissemination of the use of MRI and SbUS. Crohn's disease is a chronic inflammatory condition of the bowel that predominately affects the young and requires lifelong medical and often surgical therapy [1]. It affects approximately 60 000 people in the UK (around 1 in 1000), with between 3000 and 6000 new diagnoses made each year. Crohn's disease can affect the digestive system anywhere from the mouth to the anus, but most commonly affects the small intestine and/or colon. Despite advances in technology, the small bowel remains relatively inaccessible to conventional endoscopic techniques. Thus, radiological imaging plays a major role in the assessment and diagnosis of both luminal small bowel disease and extra-enteric complications.Although barium fluoroscopy and CT remain the conventional tests used to investigate Crohn's disease, both impart a significant radiation dose to patients [2,3]. This is of major im...

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Ultrasonography as a primary diagnostic tool in patients with inflammatory disease and tumors of the small intestine and large bowel

Cited by 83 publications

References 27 publications

Ultrasound and magnetic resonance imaging in Crohn's disease: a comparison

Ultrasound and magnetic resonance imaging in Crohn's disease: a comparison

Eosinophilic gastroenteritis: percutaneous biopsy under ultrasound guidance

Use of small bowel imaging for the diagnosis and staging of Crohn’s disease—a survey of current UK practice

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