There is good agreement between MR enterography and bowel ultrasound with regards to disease location and activity in paediatric inflammatory bowel disease

Barber, Joy L.; Maclachlan, Jody; Planche, Katie; Furman, M; Crespi, Daniel; Bab, Natalie; Beal, Isobel

doi:10.1016/j.crad.2017.02.008

Cited by 22 publications

(15 citation statements)

References 25 publications

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“…In review of the current literature, multiple studies have recently been published evaluating the diagnostic agreement between MRE and US in the initial diagnosis; evaluation of disease activity and extent of disease; and for detection of complications in IBD [10,14,[20][21][22][23]. There is inconsistent use in identifying any one of these as a diagnostic gold standard reference due to study design variability.…”

Section: Resultsmentioning

confidence: 99%

“…In 2008, a meta-analysis by Horsthuis et al [8] showed no significant difference in the diagnostic accuracy using magnetic resonance imaging (MRI), CT, or US in evaluating patients with IBD. Although it has been difficult to replicate these data, multiple studies have shown excellent sensitivity and specificity for US compared with other readily available cross-sectional imaging techniques in North America while identifying some advantages and disadvantages of its use [9][10][11][12][13][14][15]. US is particularly effective in the management of Crohn's disease for diagnosis and monitoring treatment response and complications such as stenosis, abscesses, and fistulae [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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Underutilization of Bowel Ultrasound in North America in Children with Inflammatory Bowel Disease

Gamboa

Molle-Rios

Anupindi

2019

Dig Dis

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Background: Inflammatory bowel disease (IBD) is a chronic relapsing disease that requires evaluation using multiple objective tools. In Europe, bowel ultrasound (US) is a widely accepted modality used for the management of patients with IBD; however, its use in North America has only recently emerged as a potential technique. Objectives: Our goal was to identify current practice patterns of pediatric gastroenterologists and radiologists using bowel US in patients with IBD and highlight perceived limitations to the widespread adoption of this modality in North America. Methods: A 14-question survey was e-mailed to the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition internet bulletin board composed of 3,058 subscribers from 51 countries; the Society of Pediatric Radiology listserv composed of 1,917 subscribers worldwide; and the Society of Chairs of Radiology at Children's Hospitals listserv. Descriptive summary statistics was used. Results: In North America, about one-quarter of gastroenterology and radiology participants reported using bowel US for IBD; over 3-fourths expressed an interest in using US more often. Bowel US was performed more frequently for Crohn's disease. Both groups agreed the main limitation to using bowel US was concern for inter-observer variability and operator-dependent factors; radiologists reported that other modalities are more effective to assess IBD, whereas gastroenterologists reported unfamiliarity with bowel US indications and techniques. Conclusions: Our data show there is significant interest among both radiologists and gastroenterologists in using bowel US. However, lack of education, insufficient training, and perceived high inter-observer variability among US technologists are limitations preventing the widespread adoption of US for IBD in North America.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Underutilization of Bowel Ultrasound in North America in Children with Inflammatory Bowel Disease

Gamboa

Molle-Rios

Anupindi

2019

Dig Dis

View full text Add to dashboard Cite

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“…It is largely used in clinical practice for abdominal complaints or check-up examinations. US was found to have 79.7% sensitivity and 96.7% specificity [29] in assessing the extension and activity of IBD [30], with a good concordance with the MRE findings [23,31]. In a recent systematic review in pediatric IBD, van Wassenaer et al [30] concluded that the increased bowel wall thickness (BWT), bowel wall vascularization, presence of enlarged lymph nodes, alteration of wall stratification, creeping fat, abscesses or other complications and the absence of colonic haustration were the major US criteria for IBD.…”

Section: Introductionmentioning

confidence: 64%

“…Among the imaging techniques, Magnetic Resonance Enterography (MRE) has high accuracy in identifying the bowel wall modifications and the disease complications [11,22]. However, high-quality images in children are more difficult to be obtained when compared to adults [23], due to the movement artefacts, poor acceptance of the oral contrast and the need of general anaesthesia [24]. The low accessibility, long examination time, need for specific radiological competence and high cost are other limits of this method [25,26].…”

Section: Introductionmentioning

confidence: 99%

The value of abdominal ultrasonography compared to colonoscopy and faecal calprotectin in following up paediatric patients with ulcerative colitis

et al. 2021

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Aim: To evaluate the value of abdominal ultrasonography (US) in the follow-up of paediatric patients with ulcerative colitis (UC) compared to faecal calprotectin (FC) and colonoscopy. Material and method: In this retrospective study we enrolled 30 paediatric patients previously diagnosed with UC, examined by abdominal US and colonoscopy within the same week. FC was also determined during the same week. Disease activity was established using the paediatric ulcerative colitis activity index (PUCAI). The global endoscopic activity was evaluated using the Mayo endoscopic subscore. Results: Endos-copy revealed pathological findings of active disease in 27 out of 30 patients; 3 patients were in endoscopic remission. Only 18 of them had clinical active disease (PUCAI >10), [sensitivity (Se) 66.7% and specificity (Sp) 33% of PUCAI in detecting endoscopic active disease). Twenty-three (76.7%) patients had FC >250 mcg/g, but in 2 of these cases the colonoscopy was normal (Se 77.8% and Sp 33.3% in detecting active disease). At US examination, pathological findings (increased bowel wall thickness, hypervascularity, lymphadenopathies, and/or mesenteric inflammatory fat) were found in 27 patients (90%), all with endoscopic active disease (agreement US - colonoscopy, at patient level, k=1.0, p<0.001, Se 100% and Sp 100%). At seg-ment level (totally 180 bowel segments examined by US), the overall agreement between US and colonoscopy was k=0.767, p<0.001, Se 86.5%, Sp 90.1%. Of the 27 patients with US pathological findings in any of colonic segments, 23 had FC >250 mcg/g (85.1%). The inter-observer agreement for the US measurements had an overall ICC of 0.926 with p<0.001. Conclusion: Abdominal US findings demonstrate a good to excellent concordance with endoscopic examination and are correlated with elevated FC levels. Therefore, US appears as an accurate technique in assessing activity in patients with UC and might replace colonoscopic evaluation for the follow-up.

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“…TUS is an inexpensive, readily available option in the assessment of pediatric CD, with a reported sensitivity of between 74 and 88% . Some groups have demonstrated results comparable to MRE, but it can fail to detect proximal small bowel lesions reliably, with reported sensitivity as low as 50% . This has led to interest in administering oral contrast prior to ultrasonography to promote bowel loop distension to enhance the clarity of visualization of adjacent bowel loops .…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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Aim To compare the diagnostic yield of small intestinal contrast ultrasonography (SICUS) with magnetic resonance enterography (MRE) in routine clinical practice in a cohort of pediatric patients investigated for Crohn's disease (CD) attending a UK tertiary center. Methods and Results Patients with suspected or established CD who underwent SICUS were identified retrospectively. SICUS was compared to conventional transabdominal ultrasound (TUS), ileocolonoscopy (IC), and MRE. The accuracy and agreement of SICUS in detecting small bowel lesions and CD‐related complications were assessed using kappa (κ) coefficient statistics. A total of 93 patients (median age 15 years, range 2–17, 49 male) underwent SICUS; 58 had suspected and 35 had established CD. In suspected CD, sensitivity and specificity of SICUS in detecting CD small bowel lesions were 81.8 and 100% and for TUS 85.7 and 87.5%, respectively. In established CD, sensitivity and specificity of SICUS were 98.7 and 100% and TUS 80 and 100%, respectively. Agreement between SICUS and IC was substantial for the presence of lesions (κ = 0.73) but fair in TUS (κ = 0.31). Agreement between SICUS and IC was almost perfect for detecting strictures (κ = 0.84), with a sensitivity of 100% and specificity of 97.6%. When comparing SICUS and TUS with MRE, agreement for the presence of lesions was substantial (κ = 0.63) and moderate (κ = 0.53), respectively. Agreement between SICUS and MRE was substantial for detecting strictures (κ = 0.77) and dilatation (κ = 0.68). Conclusions SICUS offers a radiation‐free alternative for assessing pediatric small bowel CD, with diagnostic accuracy that is comparable to MRE and IC, supporting its wider use in routine practice.

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There is good agreement between MR enterography and bowel ultrasound with regards to disease location and activity in paediatric inflammatory bowel disease

Cited by 22 publications

References 25 publications

Underutilization of Bowel Ultrasound in North America in Children with Inflammatory Bowel Disease

Underutilization of Bowel Ultrasound in North America in Children with Inflammatory Bowel Disease

The value of abdominal ultrasonography compared to colonoscopy and faecal calprotectin in following up paediatric patients with ulcerative colitis

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

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