Comparison of small intestinal contrast ultrasound with magnetic resonance enterography in pediatric Crohn's disease

Hakim, Aishah; Alexakis, Christopher; Pilcher, James; Tzias, Demitrios; Mitton, Sally G.; Paul, Thankam; Saxena, Sonia; Pollok, Richard; Kumar, Shankar

doi:10.1002/jgh3.12228

Cited by 11 publications

(21 citation statements)

References 46 publications

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“…The remaining 42 articles were assessed for eligibility with full text and 31 articles were excluded for the following reasons: (1) no evaluation of diagnostic performance (i.e., evaluation of the correlation between US and MRE, n = 11), (2) no evaluation of both US and MRE (did not consider both US and MRE as imaging modality or reference standard, n = 3), (3) insufficient information to generate a two-by-two table ( n = 3), (4) mixed study population with patients with ulcerative colitis ( n = 4), (5) conference abstract only and no full text available ( n = 8), (6) study presenting sensitivity results alone ( n = 1), and (7) different endpoints for diagnostic performance (i.e., stricture, n = 1). Finally, 11 studies [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ] comprising 752 patients evaluating the diagnostic performance of US and/or MRE for active bowel lesions were included ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Characteristics of the study design and population are listed in Table 1 . A total of 10 of the 11 studies had a prospective design [ 17 , 18 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ], while only one was a retrospective study [ 20 ] Furthermore, the majority of studies have been conducted in Europe [ 17 , 18 , 19 , 20 , 21 , 23 , 24 , 25 , 26 ]. The total number of enrolled patients ranged from 17 to 284.…”

Section: Resultsmentioning

confidence: 99%

“…The total number of enrolled patients ranged from 17 to 284. Most of the studies were investigated by using per-patient analyses, while three studies were investigated by using per-segment analyses, with the total number of included lesions ranging from 91 to 426 [ 18 , 23 , 27 ] Most studies were conducted on adult populations, except for three that were pediatric studies [ 18 , 20 , 23 ]. The status of CD was mostly confirmed, except two studies that involved suspected CD [ 18 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

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Comparison of Diagnostic Performance of Ultrasonography and Magnetic Resonance Enterography in the Assessment of Active Bowel Lesions in Patients with Crohn’s Disease: A Systematic Review and Meta-Analysis

et al. 2022

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We aimed to evaluate and compare the diagnostic performances of ultrasonography (US) and magnetic resonance enterography (MRE) in assessing active bowel lesions in patients with Crohn’s disease (CD). Materials and Methods: We searched PubMed and EMBASE for studies in which US and MRE were used to assess active bowel lesions in CD patients. Bivariate random effect meta-analytic methods were used to estimate pooled sensitivity, specificity, and hierarchical summary receiver operating characteristic (HSROC) curves. We performed a meta-regression analysis to explore the source of study heterogeneity. Results: Eleven studies involving 752 patients were included. US exhibited a pooled sensitivity of 86% (95% confidence interval (CI) 72–94), pooled specificity of 88% (95% CI 78–94), and HSROC of 0.93 in 10 studies. MRE exhibited a pooled sensitivity of 88% (95% CI 76–95), pooled specificity of 87% (95% CI 73–95), and an HSROC of 0.94 in eight studies. In seven studies comparing the diagnostic performances of US and MRE, the summary sensitivity of US and MRE were 86% (95% CI 65–96, I2 = 92.1) and 86% (95% CI 72–93, I2 = 88.1) (p = 0.841), respectively. The summary specificity of US and MRE were 87% (95% CI 78–93, I2 = 79.8%) and 84% (72–90, I2 = 72.5%) (p = 0.431), respectively, which showed no statistical differences. On meta-regression analysis, studies from Europe (p = 0.002), those that used linear US probes (p = 0.012), those on small bowel lesions (p = 0.01), and those with outcomes as combined features (active inflammation) reported higher US sensitivity than those from other regions, those that used both linear and convex US probes, those on small and large bowels, and those with outcome as one feature (bowel wall thickening or ulcer). Studies with pediatric patients (p = 0.001), those with reference standards including US (p = 0.001), and outcomes as combined features (p = 0.01) reported higher MRE specificity than those with adult populations, reference standards other than the US, and outcomes as one feature. Conclusions: In spite of considerable heterogeneity in the included studies, both US and MRE can diagnose active bowel lesions with comparable diagnostic accuracy in patients with CD. The study region, type of US probe, lesion location, investigated outcome for US sensitivity and study population, reference standards, and investigated outcomes for MRE specificity were potential sources of heterogeneity.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Comparison of Diagnostic Performance of Ultrasonography and Magnetic Resonance Enterography in the Assessment of Active Bowel Lesions in Patients with Crohn’s Disease: A Systematic Review and Meta-Analysis

et al. 2022

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“…Small-intestine contrast enhanced Ultrasound Sonography (SICUS) has gained importance in different indications of structural bowel diseases. SICUS can be used to describe the contrast behavior of the bowel wall and to exclude possible complications such as abscesses, strictures and fistulas [17,35].…”

Section: Discussionmentioning

confidence: 99%

Contrast enhanced ultrasonography (CEUS) a novel tool to detect intestinal epithelial barrier dysfunction in severe COVID-19 disease

Tews

Kandulski

Schmid

et al. 2022

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Ten patients with confirmed COVID-19 disease were studied. Nine patients required intensive care treatment, among them four needed extracorporeal membrane oxygenation (ECMO). Contrast enhanced ultrasonography (CEUS) was performed by one experienced investigator as a bolus injection of up to 2.4 ml of sulphur hexafluoride microbubbles via a central venous catheter. B-Mode evaluation and strain elastography showed mural edema of the small bowel with a thickness of up to 10 mm in all patients. We applied color coded Doppler sonography (CCDS) and power mode with flow-adapted parameters and early, dynamic capillary arterial contrast enhancement of bowel wall structures <10 s to assess perfusion of the small bowel. In all patients, reactive hyperemia was seen in the entire small bowel. In a subgroup of seven patients microbubbles translocated into the intestinal lumen. Thus, high-grade intestinal barrier disruption secondary to SARSCoV-2 infection can be postulated in these patients. This is the first description of perfusion changes and a disruption of the small bowel epithelial barrier in COVID-19 Patients using contrast ultrasonography and elastography.

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“…In case of stricturing or penetrating phenotypes, small intestine contrast-enhanced ultrasonography (SICUS) performed 30–40 min after the ingestion of 500–750 mL of oral contrast such as polyethylene glycol (PEG) could be very useful in patients with CD, allowing a more accurate characterization of the bowel wall and loops [ 43 ].…”

Section: Small Intestine Contrast-enhanced Ultrasonography (Sicus)mentioning

confidence: 99%

Role of Multiparametric Intestinal Ultrasound in the Evaluation of Response to Biologic Therapy in Adults with Crohn’s Disease

et al. 2022

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Crohn’s disease is one of the two most common types of inflammatory bowel disease. Current medical therapies are based on the use of glucocorticoids, exclusive enteral nutrition, immunosuppressors such as azathioprine and methotrexate, and biological agents such as infliximab, adalimumab, vedolizumab, or ustekinumab. International guidelines suggest regular disease assessment and surveillance through objective instruments to adjust and personalize the therapy, reducing the overall rates of hospitalization and surgery. Although endoscopy represents the gold-standard for surveillance, its frequent use is strongly bordered by associated risks and costs. Consequently, alternative non-invasive tools to objectify disease activity and rule active inflammation out are emerging. Alongside laboratory exams and computed tomography or magnetic resonance enterography, intestinal ultrasonography (IUS) shows to be a valid choice to assess transmural inflammation and to detect transmural healing, defined as bowel wall thickness normalization, no hypervascularization, normal stratification, and no creeping fat. Compared to magnetic resonance imaging (MRI) or computed tomography, CT scan, IUS is cheaper and more widespread, with very similar accuracy. Furthermore, share wave elastography, color Doppler, and contrast-enhanced ultrasonography (CEUS) succeed in amplifying the capacity to determine the disease location, disease activity, and complications. This review aimed to discuss the role of standard and novel ultrasound techniques such as CEUS, SICUS, or share wave elastography in adults with Crohn’s disease, mainly for therapeutic monitoring and follow-up.

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Comparison of small intestinal contrast ultrasound with magnetic resonance enterography in pediatric Crohn's disease

Cited by 11 publications

References 46 publications

Comparison of Diagnostic Performance of Ultrasonography and Magnetic Resonance Enterography in the Assessment of Active Bowel Lesions in Patients with Crohn’s Disease: A Systematic Review and Meta-Analysis

Comparison of Diagnostic Performance of Ultrasonography and Magnetic Resonance Enterography in the Assessment of Active Bowel Lesions in Patients with Crohn’s Disease: A Systematic Review and Meta-Analysis

Contrast enhanced ultrasonography (CEUS) a novel tool to detect intestinal epithelial barrier dysfunction in severe COVID-19 disease

Role of Multiparametric Intestinal Ultrasound in the Evaluation of Response to Biologic Therapy in Adults with Crohn’s Disease

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