Differentiation of Inflammatory From Fibrotic Ileal Strictures among Patients with Crohn's Disease Based on Visual Analysis: Feasibility Study Combining Conventional B-Mode Ultrasound, Contrast-Enhanced Ultrasound and Strain Elastography

Quaia, Emilio; Gennari, Antonio Giulio; Cova, Maria Assunta; Beek, Edwin Jacques Rudolph van

doi:10.1016/j.ultrasmedbio.2017.11.015

Cited by 42 publications

(68 citation statements)

References 31 publications

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“…After duplicates were removed, 31 studies (26 full text articles [8, 11 -14, 16, 20 -39] and 5 abstracts [40 -44] were assessed for eligibility. Of the 31 records selected, 2 [20,29] were excluded because they used other semi-quantitative or color scales as a parameter of bowel stiffness, 1 reported the results in kPa [44], 11 [8,11,12,16,23,24,27,28,31,33,34] were review articles, 3 [21,22,32] were excluded as they used magnetic resonance as a reference standard, and 8 [13, 30, 35 -38, 40, 43] for other reasons (▶ Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

Role of Ultrasound Elastography in the Detection of Fibrotic Bowel Strictures in Patients with Crohn’s Disease: Systematic Review and Meta-Analysis

et al. 2019

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Purpose To perform a systematic review with meta-analysis to assess whether ultrasound elastography can have a diagnostic role in detecting fibrotic bowel strictures in patients with Crohn’s disease. Materials and Methods MEDLINE via the PubMed, Ovid Embase, Scopus and Cochrane Library databases, and abstracts of international conference proceedings were searched up to March 31, 2018. Studies were included if they assessed the performance of abdominal ultrasound elastography in detecting fibrotic bowel strictures in patients with Crohn’s disease using histology or the need for surgery after medical treatment as a reference standard. The quality of the studies was assessed using Quality Assessment of Diagnostic Accuracy Studies. Results 6 studies including a total of 217 patients with Crohn’s disease and 231 bowel segments, of which 76 were bowel segments with fibrotic stricture, were selected. Three studies used strain ratio and three studies used strain value as parameters of bowel stiffness. Both the pooled standardized mean strain ratio and the pooled standardized mean strain value were higher in bowel segments with fibrotic strictures than in those without fibrotic strictures with a standardized mean difference of 0.85 (95 % confidence level [CI]: 0 to 1.71; p = 0.05) and 1.0 (95 % CI: –0.11 to 2.10; p = 0.08), respectively. There was a high heterogeneity between studies. All studies were at “high risk” or “unclear risk” of bias. Conclusion Ultrasound elastography could be able to detect fibrotic bowel strictures in patients with Crohn’s disease. Well-designed high quality diagnostic studies with a large sample size are needed.

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Section: Resultsmentioning

confidence: 99%

Role of Ultrasound Elastography in the Detection of Fibrotic Bowel Strictures in Patients with Crohn’s Disease: Systematic Review and Meta-Analysis

et al. 2019

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“…Visual observation of the elastography image is, therefore, an immediate method, but interpretation repeatability is poor if the appropriate classification systems are not adopted. Some classification systems and scores are proposed in the literature [6,[8][9][10][11], but no studies compare them, nor subsequent studies confirm their effectiveness (by authors other than the proponents). The numerous SE classification systems and scores indicate the difficulty linked to the interpretation of the various elastography color patterns obtained in Crohn's disease.…”

Section: Discussionmentioning

confidence: 99%

“…Quaia et al have recently updated the elastography classification of bowel stenosis in Crohn's disease [8] and divided it into four main categories (a = homogeneous stiff wall, corresponding to Fufezan's type C; b = mainly blue-green/stiff stratified wall; c = mainly green-red/soft stratified wall; d = nonstratified wall with uneven appearance and color mix, green/ blue if mainly stiff wall or green/red if mainly elastic wall).…”

Section: Strain Elastography Using Visual Scan Mean Hrd and Elx2/1 mentioning

confidence: 99%

Strain elastography in Crohn’s disease: the role of visual observation and semiquantitative parameters

et al. 2018

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Strain elastography is a recently developed ultrasound method that seems to contribute to the diagnosis and monitoring of inflammatory bowel diseases. This pictorial essay aims to present the feasibility of strain elastography in clinical practice by comparing visual observation and semiquantitative parameters with endoscopic or radiological images in some common cases of Crohn's disease. In our opinion, strain elastography with visual observation is easily performed in connection with B-mode ultrasound and color Doppler imaging and may provide relevant information. Strain elastography with the elaboration of semiquantitative parameters is not as immediate as the visual observation method, but it seems to provide more objective data and seems more appropriate for monitoring the evolution of the disease. However, for the elastographic method to extensively contribute in inflammatory bowel diseases, standardization and further studies are required to confirm the promising results already reported in the literature. Keywords Gastrointestinal ultrasound • Strain elastography • Bowel strain elastography • Crohn's disease SOMMARIO L'elastografia Strain è una recente metodica ecografica che sembra avere un ruolo nella diagnosi e nel monitoraggio delle malattie infiammatorie intestinali. Lo scopo di questo Pictorial Essay è di verificare la fattibilità dell'elastografia Strain nella pratica clinica confrontando l'osservazione visiva e i parametri semi-quantitativi con immagini endoscopiche o radiologiche in alcuni casi comuni di malattia di Crohn. A nostro parere, l'elastografia strain con osservazione visiva è facilmente eseguibile in connessione con l'ecografia B-mode ed il color Doppler e può fornire informazioni rilevanti. L'elastografia strain con l'elaborazione di parametri semiquantitativi non è immediata come il metodo di osservazione visiva, ma sembra fornire dati più oggettivi e sembra più appropriata per monitorare l'evoluzione della malattia. Tuttavia, affinché il metodo elastografico possa avere un ruolo più diffuso nelle malattie infiammatorie dell'intestino, sono necessari la standardizzazione del metodo e ulteriori studi che confermino i risultati promettenti già riportati in letteratura.

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“…If combined with elastography, an advanced ultrasound technique that can assess tissue stiffness, CEUS may improve our understanding and management of diseased bowel segments with varying degrees of fibrosis and inflammation. 20,21 Vesicoureteral Reflux…”

Section: Organ Perfusionmentioning

confidence: 99%

Advanced Ultrasound Techniques for Pediatric Imaging

2019

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Ultrasound has become a useful tool in the workup of pediatric patients because of the highly convenient, cost-effective, and safe nature of the examination. With rapid advancements in anatomic and functional ultrasound techniques over the recent years, the diagnostic and interventional utility of ultrasound has risen tremendously. Advanced ultrasound techniques constitute a suite of new technologies that employ microbubbles to provide contrast and enhance flow visualization, elastography to measure tissue stiffness, ultrafast Doppler to deliver high spatiotemporal resolution of flow, three-and four-dimensional technique to generate accurate spatiotemporal representation of anatomy, and high-frequency imaging to delineate anatomic structures at a resolution down to 30 mm. Application of these techniques can enhance the diagnosis of organ injury, viable tumor, and vascular pathologies at bedside. This has significant clinical implications in pediatric patients who are not easy candidates for lengthy MRI or radiation-requiring examination, and are also in need of a highly sensitive bedside technique for therapeutic guidance. To best use the currently available, advanced ultrasound techniques for pediatric patients, it is necessary to understand the diagnostic utility of each technique. In this review, we will educate the readers of emerging ultrasound techniques and their respective clinical applications.

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Differentiation of Inflammatory From Fibrotic Ileal Strictures among Patients with Crohn's Disease Based on Visual Analysis: Feasibility Study Combining Conventional B-Mode Ultrasound, Contrast-Enhanced Ultrasound and Strain Elastography

Cited by 42 publications

References 31 publications

Role of Ultrasound Elastography in the Detection of Fibrotic Bowel Strictures in Patients with Crohn’s Disease: Systematic Review and Meta-Analysis

Role of Ultrasound Elastography in the Detection of Fibrotic Bowel Strictures in Patients with Crohn’s Disease: Systematic Review and Meta-Analysis

Strain elastography in Crohn’s disease: the role of visual observation and semiquantitative parameters

Advanced Ultrasound Techniques for Pediatric Imaging

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