Bowel Ultrasonography in the Management of Crohnʼs Disease. A Review with Recommendations of an International Panel of Experts

Calabrese, Emma; Maaser, Christian; Zorzi, Francesca; Kannengießer, Klaus; Hanauer, Stephen B.; Bruining, David H.; Iacucci, Marietta; Maconi, Giovanni; Novak, Kerri L.; Panaccione, Remo; Strobel, D; Wilson, Stephanie R.; Watanabe, Mamoru; Pallone, Francesco; Ghosh, Subrata

doi:10.1097/mib.0000000000000706

Cited by 148 publications

(116 citation statements)

References 92 publications

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“…US is a noninvasive, radiation‐free, and inexpensive modality compared with CT, MRI, and endoscopy . Intestinal US has been reported useful for diagnosing of IBD and assessment of IBD disease activity . A recent meta‐analysis showed that US has a high diagnostic accuracy for detecting CD .…”

Section: Discussionmentioning

confidence: 99%

“…24,25 Intestinal US has been reported useful for diagnosing of IBD and assessment of IBD disease activity. 13,26 A recent meta-analysis showed that US has a high diagnostic accuracy for detecting CD. 8 The sensitivity and specificity of intestinal US in assessment of CD activity by evaluating intestinal wall inflammation were 85% and 91%, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Usefulness of intestinal real‐time virtual sonography in patients with inflammatory bowel disease

Kawai

Iijima

Shinzaki

et al. 2019

J of Gastro and Hepatol

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Background and Aim Transabdominal ultrasonography (US) examination for the intestine is often difficult, and its precedence for intestinal examination depends on accessibility to experienced ultrasonographers. Real‐time virtual sonography (RVS) assists examination of US as a fusion method by synchronizing US images with pre‐captured computed tomography or magnetic resonance images. We aimed to evaluate the feasibility to use RVS for the examination of the intestine. Methods The time to scan three parts of the intestine was compared between conventional US and RVS in seven participants without intestinal diseases. Whether RVS accurately synchronized US images with reference images of intestinal target lesions was judged in 20 patients with inflammatory bowel disease. Results Examination time to scan the ascending colon and the ileocecum using intestinal RVS was significantly shorter than that using conventional US alone (36.7 vs 50.0 s [P = 0.0313] and 35.4 vs 66.4 s [P = 0.0156], respectively) in participants without intestinal diseases. Well‐synchronized US images of the intestinal lesions, such as stenosis, with reference computed tomography/magnetic resonance images were obtained by RVS in all the lesions in the fixed parts of the colon (ascending and descending colon), and images of nine lesions in 12 lesions (75%) were well synchronized in the unfixed part of the intestine in Crohn's disease patients. Conclusion Real‐time virtual sonography significantly reduced the examination time of intestinal US. Intestinal RVS can help the ultrasonographer to guide the US probe to detect and monitor intestinal lesions by synchronizing reference images, especially in inflammatory bowel disease patients (UMIN Clinical Trials Registry number: UMIN000011571).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Usefulness of intestinal real‐time virtual sonography in patients with inflammatory bowel disease

Kawai

Iijima

Shinzaki

et al. 2019

J of Gastro and Hepatol

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“…The global sensitivity of intestinal US for the primary diagnosis of CD has been assessed within many meta-analyses, showing a good diagnostic accuracy. In one of these meta-analyses [50], intestinal US showed sensitivity of 79.7% and specificity of 96.7% in diagnosing patients with suspected CD and detected ileal CD with sensitivity and specificity of 92.7% and 88.2%, respectively, and colonic CD with 81.8% sensitivity and 95.3% specificity. The conclusion is that US has better accuracy for proximal lesions [50].…”

Section: Crohn's Diseasementioning

confidence: 99%

“…In one of these meta-analyses [50], intestinal US showed sensitivity of 79.7% and specificity of 96.7% in diagnosing patients with suspected CD and detected ileal CD with sensitivity and specificity of 92.7% and 88.2%, respectively, and colonic CD with 81.8% sensitivity and 95.3% specificity. The conclusion is that US has better accuracy for proximal lesions [50]. Another research on patients with suspected CD, which used colonoscopy and MRI as comparative investigations, showed a high diagnostic value of intestinal US, having a sensitivity of 94%, a specificity of 97%, positive predictive value (PPV) 97%, and negative predictive value (NPV) 94% [51].…”

Section: Crohn's Diseasementioning

confidence: 99%

The importance of intestinal ultrasound and elastographic techniques in inflammatory bowel diseases

Marin

Tribus

Fierbinţeanu-Braticevici

2018

Med Ultrason

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Inflammatory bowel diseases have an important impact upon the economic and social status due to their increasing incidence and prevalence, often affecting young people. At the moment, the therapeutic goal goes beyond the improvement of symptoms and laboratory parameters, being represented by endoscopic mucosal healing, changing the disease’s natural history. Even though endoscopy is the gold standard for the assessment of mucosal healing, it is an invasive maneuver and it lacks good repeatability. These patients require frequent evaluation; therefore, interest for noninvasive techniques has risen.As a consequence, the importance of intestinal ultrasound has increased lately and recent studies support its use to assess the degree of inflammation, to differentiate between remission and relapse, to monitor therapy response and guide treatment, to evaluate prognosis, and to diagnose complications. Another promising noninvasive imagistic technique is elastography which has gained interest because of its capacity to discriminate between inflammatory and fibrotic tissue, taking into account the different therapeutic options for the fibrotic strictures compared to inflammatory processes. This review summarizes the actual recommendations regarding the use of intestinal ultrasound and elastographic techniques for the diagnosis and monitoring of inflammatory bowel diseases.

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“…On the other hand, non-hepatic indications for CEUS include the management of IBD (estimation of disease activity, distinction between fibrous and inflammatory strictures, characterisation of suspected abscesses or to confirm and follow the route of fistulas) or pancreatic diseases (to characterise pancreatic focal lesions or to depict necrotic areas in the context of acute pancreatitis) [43, 50, 51, 53, 54, 63-65]. …”

Section: The Role For Us In Gastroenterologymentioning

confidence: 99%

Ultrasonography in Gastroenterology: The Need for Training

Pinto¹,

Azevedo²,

Pereira³

et al. 2018

GE Port J Gastroenterol

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The use of ultrasonography (US) as an imaging modality in medicine has spread across almost every clinical specialty. This diffusion is based on the simplicity, accessibility, portability and affordability of the technique producing real-time high-resolution images using non-ionising radiation. On the other hand, this trend also extended the technique to settings other than healthcare, such as public facilities, private houses or remote sites. This tendency can be observed worldwide, from developing countries to prestigious medical schools and tertiary referral hospitals. Furthermore, point-of-care US (POCUS), i.e., US executed at the patient’s bedside to obtain real-time objective information with diagnostic and clinical monitoring purposes or to guide invasive procedures, has been incorporated in many specialties. In gastroenterology, despite the essential role of endoscopy, clinical practice is highly dependent on non-endoscopic imaging techniques. However, as in other specialties, the indications of US in gastroenterology have been increasing steadily, covering a broad range of conditions. In response to the generalised employment of US by non-radiologists, institutions such as the European Federation of Societies for Ultrasound in Medicine and Biology and the Royal College of Radiologists issued recommendations to ensure high-quality practice. These theoretical and practical requisites include performing a certain number of examinations and mandatory skills in order to achieve certification to execute unsupervised US. Therefore, there is a need for modern gastroenterology to include US as a basic skill in its clinical practice. To ensure the provision of high-quality US, adequate instruction of future specialists should be guaranteed by the gastroenterology departments and required in the residency training programme.

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Bowel Ultrasonography in the Management of Crohnʼs Disease. A Review with Recommendations of an International Panel of Experts

Abstract: Bowel US is a tool for evaluation of CD lesions in terms of complications, postoperative recurrence, and monitoring response to medical therapy; it reliably detects postoperative recurrence and complications, as well as offers the possibility of monitoring disease progression.

Cited by 148 publications

References 92 publications

Usefulness of intestinal real‐time virtual sonography in patients with inflammatory bowel disease

Usefulness of intestinal real‐time virtual sonography in patients with inflammatory bowel disease

The importance of intestinal ultrasound and elastographic techniques in inflammatory bowel diseases

Ultrasonography in Gastroenterology: The Need for Training

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