Contrast-enhanced ultrasound in the differentiation between phlegmon and abscess in Crohn's disease and other abdominal conditions

Ripollés, Tomás; Martínez-Pérez, María Jesús; Paredes, José María Rubio; Vizuete, José María Jiménez; García-Martínez, Esteban; Jiménez-Restrepo, David H.

doi:10.1016/j.ejrad.2013.05.043

Cited by 89 publications

(61 citation statements)

References 28 publications

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“…These areas typically are hypoechoic at gray-scale US, lack a discrete wall (unlike abscesses), and may demonstrate associated hyperemia at color or power Doppler US (Fig 18). A recent study by Ripollés et al (31) shows that contrast-enhanced US performed after intravenous microbubble contrast material injection can be used to accurately differentiate areas of intra-abdominal phlegmon from abscess according to the pattern of enhancement, with a high degree of specificity.…”

Section: Abnormal Fluidmentioning

confidence: 99%

Pediatric Small Bowel Crohn Disease: Correlation of US and MR Enterography

Dillman¹,

Smith

Sanchez³

et al. 2015

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Small bowel Crohn disease is commonly diagnosed during the pediatric period, and recent investigations show that its incidence is increasing in this age group. Diagnosis and follow-up of this condition are commonly based on a combination of patient history and physical examination, disease activity surveys, laboratory assessment, and endoscopy with biopsy, but imaging also plays a central role. Ultrasonography (US) is an underutilized well-tolerated imaging modality for screening and follow-up of small bowel Crohn disease in children and adolescents. US has numerous advantages over computed tomographic (CT) enterography and magnetic resonance (MR) enterography, including low cost and no required use of oral or intravenous contrast material. US also has the potential to provide images with higher spatial resolution than those obtained at CT enterography and MR enterography, allows faster examination than does MR enterography, does not involve ionizing radiation, and does not require sedation or general anesthesia. US accurately depicts small bowel and mesenteric changes related to pediatric Crohn disease, and US findings show a high correlation with MR imaging findings in this patient population.

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Section: Abnormal Fluidmentioning

confidence: 99%

Pediatric Small Bowel Crohn Disease: Correlation of US and MR Enterography

Dillman¹,

Smith

Sanchez³

et al. 2015

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“…Abscesses within an inflammatory loop may sometimes be difficult to distinguish from phlegmons. In these cases, the use of CEUS may be helpful in detecting unperfused areas in the tissue and in depicting the margin of debris and pus collections in order to differentiate abcesses and inflammation [16,17]. …”

Section: Criteria Of Bowel Ultrasonography In Ibdmentioning

confidence: 99%

Bowel Ultrasonography in Inflammatory Bowel Disease

Kucharzik¹

2015

Dig Dis

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Background: The diagnosis of inflammatory bowel disease (IBD) is based on a combination of endoscopic, clinical and biochemical investigations as well as cross-sectional imaging. The applications of cross-sectional imaging in IBD are manifold. Ultrasonography has emerged as an important imaging modality in the diagnosis of Crohn's disease (CD) as well as for monitoring disease progression and in the therapeutic response to CD and ulcerative colitis (UC). Key Messages: Ultrasonography is non-invasive, radiation free, cheap, easy to use and well tolerated and accepted by patients. Bowel ultrasonography can be used for the primary diagnosis of CD as it has a similar sensitivity and specificity like that of MRI and CT, particularly in the case of CD. Ultrasonography can also be used to monitor treatment response to therapy and to detect disease recurrence of CD as well as UC. In CD, ultrasonography can also be used to detect complications such as strictures as well as extramural complications, including abscesses and fistulas. Contrast-enhanced ultrasonography is a useful tool that might be helpful to detect certain indications in CD, in particular the differentiation between abscesses and inflammation. Conclusion: A variety of advantages of bowel ultrasonography over other imaging modalities suggest the more frequent use of this method to manage IBD patients in daily practice. Bowel ultrasonography should be a standard tool in IBD centers.

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“…Therefore, US plays a pivotal role in the detection of abscesses, even though it can produce false positive results [57]. An abscess is characterized by a hypoechoic, irregular, nonperistaltic and nonvascular area which can contain air visible as hyperechoic lines [61].…”

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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Contrast-enhanced ultrasound in the differentiation between phlegmon and abscess in Crohn's disease and other abdominal conditions

Cited by 89 publications

References 28 publications

Pediatric Small Bowel Crohn Disease: Correlation of US and MR Enterography

Pediatric Small Bowel Crohn Disease: Correlation of US and MR Enterography

Bowel Ultrasonography in Inflammatory Bowel Disease

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

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