Retrospective Cohort Study of Shear-Wave Elastography and Computed Tomography Enterography in Crohn’s Disease

Abstract

Distinguishing between inflammatory and fibrotic lesions drastically influences treatment decision-making regarding Crohn’s disease. However, it is challenging to distinguish these two phenotypes before surgery. This study investigates the diagnostic yield of shear-wave elastography and computed tomography enterography to distinguish intestinal phenotypes in Crohn’s disease. Thirty-seven patients (mean age, 29.51 ± 11.52; 31 men) were evaluated with average value of shear-wave elastography (Emean) and computed tomography enterography (CTE) scores. The results demonstrated that a positive correlation between the Emean and fibrosis (Spearman’s r = 0.653, p = 0.000). The cut-off value for fibrotic lesions was 21.30 KPa (AUC: 0.877, sensitivity: 88.90%, specificity: 89.50%, 95% CI:0.755~0.999, p = 0.000). The CTE score showed a positive correlation with inflammation (Spearman’s r = 0.479, p = 0.003), and a 4.5-point grading system was the optimal cut-off value for inflammatory lesions (AUC: 0.766, sensitivity: 73.70%, specificity: 77.80%, 95% CI: 0.596~0.936, p = 0.006). Combining these two metrics improved the diagnostic performance and specificity (AUC: 0.918, specificity: 94.70%, 95% CI: 0.806~1.000, p = 0.000). In conclusion, shear-wave elastography can be used to help detect fibrotic lesions and the computed tomography enterography score emerged as a feasible predictor of inflammatory lesions. The combination of these two imaging techniques is proposed to distinguish intestinal predominant phenotypes.

Differentiating benign and malignant thyroid nodules: A cross‐sectional study on the comparison of diagnostic value of ultrasound elastography and fine needle aspiration biopsy

“…There has been no study on the impact of age on TN stiffness and further research on the subject is recommended. Another fact is that ultrasound elastography‐ as shear‐wave elastography‐ is a method used in the diagnosis of inflammatory conditions 23,24 . On the other hand, TNs, especially when malignant, produce a significant amount of inflammatory burden 25,26 .…”

“…Another fact is that ultrasound elastography-as shear-wave elastography-is a method used in the diagnosis of inflammatory conditions. 23,24 On the other hand, TNs, especially when malignant, produce a significant amount of inflammatory burden. 25,26…”

WEO Newsletter: Tips and tricks for ultrasound assessment of inflammatory bowel disease

“…A strain ratio >2 predicted fibrotic stricture and need for surgery 9 . Stiffness >21 kPa on shear wave elastography was shown to predict fibrotic strictures with good accuracy (~88%) 10 …”

“…9 Stiffness >21 kPa on shear wave elastography was shown to predict fibrotic strictures with good accuracy (~88%). 10 Contrast-enhanced IUS is done using reconstituted sodium hexafluoride microbubbles administered intravenously. Several amplitude-dependent (peak enhancement and wash-in rates) and time-dependent (e.g.…”

Systematic review: Defining, diagnosing and monitoring small bowel strictures in Crohn's disease on intestinal ultrasound

“…11,13,28,31,36,37,39,40,48,49,[53][54][55] In these studies, the definitions of a stricture were the same, regardless of whether the stricture was naïve or anastomotic. Ten studies failed to provide specific information on the stricture definition, 53,54,[56][57][58][59][60][61][62][63] although the main objective was CD stricture assessment. A detailed summary of the cut-offs and descriptions used for bowel wall thickness, luminal narrowing, prestenotic dilation, motility abnormalities, inflammatory fat, hyperemia and lymphadenopathy can be found in Material S1.…”