Role of US in Detection of Crohn Disease: Meta-Analysis

Fraquelli, Mirella; Colli, Agostino; Casazza, Giovanni; Paggi, Silvia; Colucci, A.; Massironi, Sara; Duca, Piergiorgio; Conte, Dario

doi:10.1148/radiol.2361040799

Cited by 266 publications

(135 citation statements)

References 44 publications

(64 reference statements)

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“…In addition, lymphoid hyperplasia is often present in the submucosa. In the small intestine, a wall thickness above 3 mm and in the colon from 2 to 3.5 mm in the proximal and distal end, respectively, are considered as pathologic [3].…”

Section: Some Pathological Conditionsmentioning

confidence: 99%

High-frequency ultrasonographic imaging of the gastrointestinal wall

Ødegaard

Nesje

Lærum

et al. 2012

Expert Review of Medical Devices

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Section: Some Pathological Conditionsmentioning

confidence: 99%

High-frequency ultrasonographic imaging of the gastrointestinal wall

Ødegaard

Nesje

Lærum

et al. 2012

Expert Review of Medical Devices

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“…The accuracy of the examination was characterized by variability between facilities and between operators, with sensitivity values ranging from 75 to 94 % and specificities of 67-100 % [45]. Similar sensitivity (85 %) emerged from a more recent systematic review by Panes et al [46].…”

Section: Ultrasoundmentioning

confidence: 81%

“…The objective of the preoperative workup should be to provide the most precise information possible on the number, extension, and characteristics of the lesions, including the presence and predominant nature (fibrotic or inflammatory) of strictures as well as the extramural extension of the inflammatory changes. Ultrasound is limited by its operator-dependency, but it is also widely available, and in addition to characterizing strictures (with or without the aid of acoustic contrast media proposed by some), it can also reveal extramural complications of Crohn's disease, although its accuracy in this setting is inferior to that of CT [42,45,90,91].…”

Section: Jejunoileal and Ileocolic Crohn's Diseasementioning

confidence: 99%

Surgery and diagnostic imaging in abdominal Crohn’s disease

et al. 2013

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Surgery is well-established option for the treatment of Crohn's disease that is refractory to medical therapy and for complications of the disease, including strictures, fistulas, abscesses, bleeding that cannot be controlled endoscopically, and neoplastic degeneration. For a condition like Crohn's disease, where medical management is the rule, other indications for surgery are considered controversial, because the therapeutic effects of surgery are limited to the resolution of complications and the rate of recurrence is high, especially at sites of the surgical anastomosis. In the authors' opinion, however, surgery should not be considered a last-resort treatment: in a variety of situations, it should be regarded as an appropriate solution for managing this disease. Based on a review of the literature and their own experience, the authors examine some of the possibilities for surgical interventions in Crohn's disease and the roles played in these cases by diagnostic imaging modalities.Riassunto La chirurgia è un'opzione terapeutica consolidata per il trattamento della malattia di Crohn refrattaria alla terapia medica e per le complicanze legate a tale patologia quali stenosi, fistole, ascessi, sanguinamento non trattabile endoscopicamente, oltre che per i casi di degenerazione neoplastica. Per condizioni come la malattia di Crohn nelle quali il trattamento medico ha un ruolo primario, altre indicazioni per la chirurgia sono controverse, poiché i suoi effetti terapeutici sono limitati alla risoluzione delle complicanze, e la frequenza di recidive è alta, soprattutto a livello dell'anastomosi. Secondo l'opinione degli autori, tuttavia, la chirurgia non deve essere considerata come ultima opzione di trattamento: in diverse situazioni dovrebbe essere ritenuta come una soluzione adeguata nel trattamento multidisciplinare della patologia. Basandosi sulla revisione della letteratura corrente e sulla propria esperienza, gli autori hanno esaminato alcune possibilità di intervento chirurgico nella malattia di Crohn ed il ruolo che svolgono in queste condizioni le tecniche di imaging.

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“…Fraquelli et al [22] compared different bowel wall thickness cutoff values in a meta-analysis. A sensitivity and specificity of 88 and 93 % respectively, were observed when a bowel wall thickness greater than 3 mm was used, and sensitivity and specificity of 75 and 97 % respectively were obtained when a threshold greater than 4 mm was used.…”

Section: Ultrasonographic Features Of the Intestinal Wall In Crohn's mentioning

confidence: 99%

“…A sensitivity and specificity of 88 and 93 % respectively, were observed when a bowel wall thickness greater than 3 mm was used, and sensitivity and specificity of 75 and 97 % respectively were obtained when a threshold greater than 4 mm was used. Thus, a cutoff of 4 mm can be considered a sensible and specific limit for primary diagnosis, while a threshold greater than 3 mm can be considered a sign of active disease during follow-up [22]. Several studies showed a relation among bowel wall thickness, clinical disease activity and endoscopic findings, using the Crohn's Disease Activity Index (CDAI) at initial diagnosis and during the clinical course of CD [23,24].…”

Section: Ultrasonographic Features Of the Intestinal Wall In Crohn's mentioning

confidence: 99%

Ultrasonographic findings in Crohn’s disease

2014

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In recent years transabdominal bowel sonography has become a first-line modality both in the diagnosis and in the follow-up of inflammatory bowel diseases, especially Crohn's disease, reaching values of sensitivity ranging from 84 to 93 %. In particular, its role is very useful in the early diagnosis of complications such as stenosis, phlegmons, abscesses and fistulae. According to the available literature the ability of US to provide information about disease activity is still under debate and further studies are necessary. In this regard, of fundamental importance is the use of additional techniques such as color-and power-Doppler and contrast-enhanced ultrasound. The purpose of this paper is to report the main sonographic intestinal and extraintestinal findings detectable in Crohn's disease.Keywords Transabdominal bowel sonography Á Crohn's disease Á Color and power Doppler Á CEUS Á Disease activity Riassunto Nel corso degli ultimi anni l'ecografia delle anse intestinali è andata affermandosi come metodica di prima linea nella diagnosi e nel follow-up delle malattie infiammatorie croniche intestinali, soprattutto nella malattia di Crohn, con valori di accuratezza diagnostica dell'84-93 %. In particolare il suo ruolo risulta preminente nella precoce diagnosi delle complicanze, quali stenosi, flemmoni, ascessi e fistole. In accordo con la letteratura disponibile più discussa rimane la capacità di fornire informazioni circa l'attività di malattia ed ulteriori studi appaiono necessari. A tal proposito è fondamentale l'utilizzo di metodiche quali color e power Doppler e l'ecografia con mezzo di contrasto (CEUS). Scopo del presente lavoro è quello di riportare i principali quadri ecografici intestinali ed extra-intestinali evidenziabili nella malattia di Crohn.

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Role of US in Detection of Crohn Disease: Meta-Analysis

Cited by 266 publications

References 44 publications

High-frequency ultrasonographic imaging of the gastrointestinal wall

High-frequency ultrasonographic imaging of the gastrointestinal wall

Surgery and diagnostic imaging in abdominal Crohn’s disease

Ultrasonographic findings in Crohn’s disease

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