Assessing the activity of perianal Crohnʼs disease: Comparison of clinical indices and computer-assisted anal ultrasound

Abstract

The diagnostic accuracy of the FDA, PDAI, and computer-assisted AUS imaging was good in assessing perianal disease activity in patients with CD. The agreement between the techniques was fair to moderate. Overall accuracy can be increased by combining the FDA or PDAI with AUS.

Incidence and clinical outcomes of intersphincteric abscesses diagnosed by anal ultrasonography in patients with crohnʼs disease

“…23,24 It is possible that a computer-based assessment of the degree of hypoechogenicity of the intersphincteric abscess might help improve the imaging-based definition of inactive lesions, as previously reported for fistulating disease. 12,25 In conclusion, intersphincteric abscesses frequently cause perianal pain in patients with CD attending a tertiary gastroenterological referral center, and should be suspected in the presence of unexplained anal pain, particularly if a fissure is palpable in the anal canal. The clinical outcome of these abscesses varies from rapidly progressive inflammation to a benign self-limiting course, but the favorable outcome observed in some patients supports a first-line conservative approach.…”

Endoanal ultrasonography may distinguish Crohn’s anal fistulae from cryptoglandular fistulae in patients with Crohn’s disease: a cross-sectional study

“…Ultrasonographic findings showing that satisfaction of two or all three criteria are satisfied may simply represent the sequel of more severe disease of longer duration that had been subjected to repeated unsuccessful surgery. It has been proposed that the hyperechoic content of the fistula tract is a sign of inflammatory activity of the fistula tract or of perianal disease as a whole [5,6]. The same type of secretions inside the fistula can also be observed by means of magnetic resonance imaging [7].…”

Monitoring Disease Activity and Progression in Crohn's Disease. A Swiss Perspective on the IBD Ahead ‘Optimised Monitoring' Recommendations

“…Anorectal US is helpful to evaluate perianal abscesses (level B). Transdermal perineal US might be helpful to evaluate the exact anatomy of perianal complications (level C) [86,87,88,89,90,91,92]. In general, MRI is preferred to a CT scan in order to avoid radiation.…”

“…Transdermal perianal US might enhance the diagnostic accuracy regarding perianal fistulae and abscesses (level C) [82,83,84,85,86,87,88,89,90,91,92]. Imaging should be performed in combination with examination under anaesthesia (level D).…”