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David H Bruining - One of the best experts on this subject based on the ideXlab platform.
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panenteric capsule endoscopy versus ileocolonoscopy plus Magnetic Resonance Enterography in crohn s disease a multicentre prospective study
BMJ Open Gastroenterology, 2020Co-Authors: David H Bruining, Salvatore Oliva, Mark R Fleisher, Monika Fischer, Joel G FletcherAbstract:Introduction Crohn’s disease diagnosis and monitoring remains a great clinical challenge and often requires multiple testing modalities. Assessing Crohn’s disease activity in the entire gastrointestinal (GI) tract using a panenteric capsule endoscopy (CE) system could be used as an alternative to colonoscopy and cross-sectional imaging. This study assessed the accuracy and safety of panenteric CE in Crohn’s disease as compared with ileocolonoscopy (IC) and/or Magnetic Resonance Enterography (MRE). Methods A prospective, multicentre study was performed in subjects with established Crohn’s disease. Individuals with proven small bowel patency underwent a standardised bowel preparation, followed by CE ingestion and IC either the same or following day. MRE, IC, and CE interpretations were performed by blinded central readers using validated scoring systems. The primary endpoint was the overall sensitivity of CE vs MRE and/or IC in Crohn’s disease subjects. Results Study enrolment included 158 subjects from 21 sites in the USA, Austria, and Israel. Of those, 99 were included in the analysis. Imaging modality scores indicated none to mild inflammation in the proximal small bowel and colon, but discrepant levels of inflammation in the terminal ileum. Overall sensitivity for active enteric inflammation (CE vs MRE and/or IC) was 94% vs 100% (p=0.125) and specificity was 74% vs 22% (p=0.001). Sensitivity of CE was superior to MRE for enteric inflammation in the proximal small bowel (97% vs 71%, p=0.021), and similar to MRE and/or IC in the terminal ileum and colon (p=0.500–0.625). There were seven serious adverse advents of which three were related to the CE device. Conclusion Panenteric CE is a reliable tool for assessing Crohn’s disease mucosal activity and extent compared with more invasive methods. This study demonstrates high performance of the panenteric CE as compared to MRE and/or IC without the need for multiple tests in non-stricturing Crohn’s disease. Trial registration number ClinicalTrials.gov NCT03241368
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consensus recommendations for evaluation interpretation and utilization of computed tomography and Magnetic Resonance Enterography in patients with small bowel crohn s disease
Gastroenterology, 2018Co-Authors: Mark E Baker, Cary G Sauer, William J. Sandborn, Ellen M Zimmermann, Edward V Loftus, Scott A Strong, Mahmoud M Alhawary, Sudha A Anupindi, David H BruiningAbstract:Computed tomography and Magnetic Resonance Enterography have become routine small bowel imaging tests to evaluate patients with established or suspected Crohn's disease, but the interpretation and use of these imaging modalities can vary widely. A shared understanding of imaging findings, nomenclature, and utilization will improve the utility of these imaging techniques to guide treatment options, as well as assess for treatment response and complications. Representatives from the Society of Abdominal Radiology Crohn's Disease-Focused Panel, the Society of Pediatric Radiology, the American Gastroenterological Association, and other experts, systematically evaluated evidence for imaging findings associated with small bowel Crohn's disease enteric inflammation and established recommendations for the evaluation, interpretation, and use of computed tomography and Magnetic Resonance Enterography in small bowel Crohn's disease. This work makes recommendations for imaging findings that indicate small bowel Crohn's disease, how inflammatory small bowel Crohn's disease and its complications should be described, elucidates potential extra-enteric findings that may be seen at imaging, and recommends that cross-sectional Enterography should be performed at diagnosis of Crohn's disease and considered for small bowel Crohn's disease monitoring paradigms. A useful morphologic construct describing how imaging findings evolve with disease progression and response is described, and standard impressions for radiologic reports that convey meaningful information to gastroenterologists and surgeons are presented.
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computed tomography and Magnetic Resonance Enterography in crohn s disease assessment of radiologic criteria and endpoints for clinical practice and trials
Inflammatory Bowel Diseases, 2016Co-Authors: Parakkal Deepak, Jeff L Fidler, Joel G Fletcher, David H BruiningAbstract:Early recognition of Crohn's disease with initiation of disease-modifying therapy has emerged as a prominent inflammatory bowel disease management strategy. Clinical practice and trials have often focused on patient symptoms, and more recently, serologic tests, stool inflammatory markers, and/or endoscopic inflammatory features for study entry criteria, treatment targets, disease activity monitoring, and to assess therapeutic response. Unfortunately, patient symptoms do not correlate well with biological disease activity, and endoscopy potentially misses or underestimates disease extent and severity in small bowel Crohn's disease. Computed tomography Enterography and Magnetic Resonance Enterography (MRE) are potential tools to identify and quantify transmural structural damage and disease activity in the small bowel. In this review, we discuss the role of computed tomography Enterography and MRE in disease management algorithms in clinical practice. We also compare the currently developed MRE-based scoring systems, their strengths and pitfalls, as well as the role for MRE in clinical trials for Crohn's disease.
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Magnetic Resonance Enterography is feasible and reliable in multicenter clinical trials in patients with crohn s disease and may help select subjects with active inflammation
Alimentary Pharmacology & Therapeutics, 2016Co-Authors: Alexandre Coimbra, Jeff L Fidler, David H Bruining, J. Rimola, T. Bengtsson, A. De Crespigny, D. Luca, P. Rutgeerts, Sharon Obyrne, William J. SandbornAbstract:Summary Background Reliable tools for patient selection are critical for clinical drug trials. Aim To evaluate a consensus-based, standardised Magnetic Resonance Enterography (MRE) protocol for selecting patients for inclusion in Crohn's disease (CD) multicenter clinical trials. Methods This study recruited 20 patients [Crohn's Disease Activity Index (CDAI) scores: <150 (n = 8); 150–220 (n = 4); 220–450 (n = 8)], to undergo ileocolonoscopy and two MREs (with and without colonic contrast) within a 14-day period. Procedures were scored centrally using, Magnetic Resonance Index of Activity (MaRIA), and both Crohn's Disease Endoscopic Index of Severity (CDEIS) and Simplified Endoscopic Score (SES-CD). Results 37 MREs were acquired. Both MREs were evaluable in 16 patients for calculation of test–retest and inter-reader reliability scores. The MaRIA scores for the terminal ileum had excellent test–retest and inter-reader reliability, with correlations >0.9. The proximal ileum showed strong within-reader agreement (0.90–0.96), and fair between-reader agreement (0.59–0.72). MRE procedures were tolerable. MaRIA scores correlated with CDEIS and SES-CD (0.63 and 0.71), but not with CDAI (0.34). MRE identified 3 patients with intra-abdominal complications, who would otherwise have been included in clinical trials. Furthermore, both MRE and ileocolonoscopy identified active bowel wall inflammation in 2 patients with CDAI 220. Data quality was good/excellent in 85% of scans, and fair or better in 96%. Conclusions Magnetic Resonance Enterography of high-quality and reproducibility was feasible in a global multi- centre setting, with evidence for improved selectivity over CDAI and ileocolonoscopy in identifying appropriate CD patients for inclusion in therapeutic intervention trials.
Karin A. Herrmann - One of the best experts on this subject based on the ideXlab platform.
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Magnetic Resonance Enterography/enteroclysis in acquired small bowel diverticulitis and small bowel diverticulosis
European Radiology, 2016Co-Authors: Bahar Mansoori, Conor P. Delaney, Joseph E. Willis, Raj M. Paspulati, Christine Schmid-tannwald, Karin A. HerrmannAbstract:Purpose Small bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in imaging. Magnetic Resonance Enterography/enteroclysis (MRE) is increasingly used to assess SB disease; awareness of the appearance of SB diverticulitis is essential to ensure appropriate management. Our aim was to systematically describe imaging characteristics of SB diverticulosis and diverticulitis in MRE. Methods This retrospective, HIPAA-compliant study identified 186 patients with suspected SB diverticulosis/diverticulitis in medical databases of two tertiary medical centres between 2005 and 2011. Patients with surgically confirmed diagnoses of SB diverticulosis/diverticulitis were included. Two observers analyzed MR images for the presence, location, number, and size of diverticula, wall thickness, and mural and extramural patterns of inflammation. Results Seven patients were recruited. MRI analysis showed multiple diverticula in all (100 %). Diverticular size ranged from 0.5 to 6 cm. Prevalence of diverticula was higher in the proximal than the distal SB (jejunum 86 %, ileum 57 %, distal ileum43%). Diverticulitis occurred in 3/7 patients (43 %) showing asymmetric bowel wall thickening and focal mesenteric inflammation. Conclusion SB diverticulitis demonstrates characteristic MRE imaging features to distinguish this rare disorder from more common diseases. Asymmetric, focal mesenteric and mural inflammation and presence of multiple diverticula are keys to diagnosis. Key points • Small bowel diverticulosis and diverticulitis is rare and often missed in imaging • Acquired small bowel diverticula are variable in size and number • Small bowel diverticulitis demonstrates characteristic features on MR Enterography/enteroclysis • A focal or segmental asymmetric small bowel inflammation should prompt the search for diverticula
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Magnetic Resonance Enterography enteroclysis in acquired small bowel diverticulitis and small bowel diverticulosis
European Radiology, 2016Co-Authors: Bahar Mansoori, Conor P. Delaney, Raj M. Paspulati, Joseph Willis, Pablo R Ros, Christine Schmidtannwald, Karin A. HerrmannAbstract:Small bowel (SB) diverticulosis is a rare disorder that may entail serious complications, including SB diverticulitis. Both are often missed in imaging. Magnetic Resonance Enterography/enteroclysis (MRE) is increasingly used to assess SB disease; awareness of the appearance of SB diverticulitis is essential to ensure appropriate management. Our aim was to systematically describe imaging characteristics of SB diverticulosis and diverticulitis in MRE. This retrospective, HIPAA-compliant study identified 186 patients with suspected SB diverticulosis/diverticulitis in medical databases of two tertiary medical centres between 2005 and 2011. Patients with surgically confirmed diagnoses of SB diverticulosis/diverticulitis were included. Two observers analyzed MR images for the presence, location, number, and size of diverticula, wall thickness, and mural and extramural patterns of inflammation. Seven patients were recruited. MRI analysis showed multiple diverticula in all (100 %). Diverticular size ranged from 0.5 to 6 cm. Prevalence of diverticula was higher in the proximal than the distal SB (jejunum 86 %, ileum 57 %, distal ileum43%). Diverticulitis occurred in 3/7 patients (43 %) showing asymmetric bowel wall thickening and focal mesenteric inflammation. SB diverticulitis demonstrates characteristic MRE imaging features to distinguish this rare disorder from more common diseases. Asymmetric, focal mesenteric and mural inflammation and presence of multiple diverticula are keys to diagnosis. • Small bowel diverticulosis and diverticulitis is rare and often missed in imaging • Acquired small bowel diverticula are variable in size and number • Small bowel diverticulitis demonstrates characteristic features on MR Enterography/enteroclysis • A focal or segmental asymmetric small bowel inflammation should prompt the search for diverticula
R Pollok - One of the best experts on this subject based on the ideXlab platform.
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comparison of small intestinal contrast ultrasound with Magnetic Resonance Enterography in pediatric crohn s disease
Journal of Gastroenterology and Hepatology, 2020Co-Authors: Aishah Hakim, Christopher Alexakis, James Pilcher, Demitrios Tzias, Sally G Mitton, Thankam Paul, Sonia Saxena, R Pollok, Shankar KumarAbstract: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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small intestinal contrast ultrasonography for the detection of small bowel complications in crohn s disease correlation with intraoperative findings and Magnetic Resonance Enterography
Journal of Gastroenterology and Hepatology, 2015Co-Authors: Shankar Kumar, Aishah Hakim, Christopher Alexakis, James Pilcher, Demitrios Tzias, V Chhaya, Johnny Vlahos, R PollokAbstract:Background and Aims In evaluating small bowel Crohn's disease (CD), small intestine contrast-enhanced ultrasonography (SICUS) is emerging as an alternative to Magnetic Resonance Enterography (MRE). This retrospective study compared the diagnostic accuracy of SICUS and MRE with surgical findings, and their level of agreement. Methods We identified a cohort of CD patients investigated by either SICUS and/or MRE that subsequently required resective bowel surgery within 6 months. The accuracy and agreement of SICUS and MRE to detect small bowel complications were compared with intraoperative findings using kappa coefficient (κ). Agreement between SICUS and MRE in those undergoing both modalities was also assessed. Results A total of 67 patients were evaluated; 25 underwent SICUS and 17 underwent MRE prior to surgery. Another 25 patients underwent both SICUS and MRE. When compared with intraoperative findings, the sensitivity of SICUS and MRE was 87.5% and 100%, respectively, in detecting strictures, 87.7% and 66.7% for fistulae, 100% for both in identifying abscesses, 100% and 66.7% for bowel dilatation, and 94.7% and 81.8% in defining bowel wall thickening. When correlating SICUS and MRE with surgery, there was a high level of agreement in localizing strictures (κ = 0.75, 0.88, respectively), fistulae (κ = 0.82, 0.79) and abscesses (κ = 0.87, 0.77). Concordance between SICUS and MRE was substantial or almost complete in identifying stricturing disease (κ = 0.84), their number and location (κ = 0.85), fistulae (κ = 0.65), and mucosal thickening (κ = 0.61). Conclusion SICUS accurately identified small bowel complications and correlated well with MRE and intraoperative findings. SICUS offers an alternative in the preoperative assessment of CD.
William J. Sandborn - One of the best experts on this subject based on the ideXlab platform.
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consensus recommendations for evaluation interpretation and utilization of computed tomography and Magnetic Resonance Enterography in patients with small bowel crohn s disease
Gastroenterology, 2018Co-Authors: Mark E Baker, Cary G Sauer, William J. Sandborn, Ellen M Zimmermann, Edward V Loftus, Scott A Strong, Mahmoud M Alhawary, Sudha A Anupindi, David H BruiningAbstract:Computed tomography and Magnetic Resonance Enterography have become routine small bowel imaging tests to evaluate patients with established or suspected Crohn's disease, but the interpretation and use of these imaging modalities can vary widely. A shared understanding of imaging findings, nomenclature, and utilization will improve the utility of these imaging techniques to guide treatment options, as well as assess for treatment response and complications. Representatives from the Society of Abdominal Radiology Crohn's Disease-Focused Panel, the Society of Pediatric Radiology, the American Gastroenterological Association, and other experts, systematically evaluated evidence for imaging findings associated with small bowel Crohn's disease enteric inflammation and established recommendations for the evaluation, interpretation, and use of computed tomography and Magnetic Resonance Enterography in small bowel Crohn's disease. This work makes recommendations for imaging findings that indicate small bowel Crohn's disease, how inflammatory small bowel Crohn's disease and its complications should be described, elucidates potential extra-enteric findings that may be seen at imaging, and recommends that cross-sectional Enterography should be performed at diagnosis of Crohn's disease and considered for small bowel Crohn's disease monitoring paradigms. A useful morphologic construct describing how imaging findings evolve with disease progression and response is described, and standard impressions for radiologic reports that convey meaningful information to gastroenterologists and surgeons are presented.
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Magnetic Resonance Enterography is feasible and reliable in multicenter clinical trials in patients with crohn s disease and may help select subjects with active inflammation
Alimentary Pharmacology & Therapeutics, 2016Co-Authors: Alexandre Coimbra, Jeff L Fidler, David H Bruining, J. Rimola, T. Bengtsson, A. De Crespigny, D. Luca, P. Rutgeerts, Sharon Obyrne, William J. SandbornAbstract:Summary Background Reliable tools for patient selection are critical for clinical drug trials. Aim To evaluate a consensus-based, standardised Magnetic Resonance Enterography (MRE) protocol for selecting patients for inclusion in Crohn's disease (CD) multicenter clinical trials. Methods This study recruited 20 patients [Crohn's Disease Activity Index (CDAI) scores: <150 (n = 8); 150–220 (n = 4); 220–450 (n = 8)], to undergo ileocolonoscopy and two MREs (with and without colonic contrast) within a 14-day period. Procedures were scored centrally using, Magnetic Resonance Index of Activity (MaRIA), and both Crohn's Disease Endoscopic Index of Severity (CDEIS) and Simplified Endoscopic Score (SES-CD). Results 37 MREs were acquired. Both MREs were evaluable in 16 patients for calculation of test–retest and inter-reader reliability scores. The MaRIA scores for the terminal ileum had excellent test–retest and inter-reader reliability, with correlations >0.9. The proximal ileum showed strong within-reader agreement (0.90–0.96), and fair between-reader agreement (0.59–0.72). MRE procedures were tolerable. MaRIA scores correlated with CDEIS and SES-CD (0.63 and 0.71), but not with CDAI (0.34). MRE identified 3 patients with intra-abdominal complications, who would otherwise have been included in clinical trials. Furthermore, both MRE and ileocolonoscopy identified active bowel wall inflammation in 2 patients with CDAI 220. Data quality was good/excellent in 85% of scans, and fair or better in 96%. Conclusions Magnetic Resonance Enterography of high-quality and reproducibility was feasible in a global multi- centre setting, with evidence for improved selectivity over CDAI and ileocolonoscopy in identifying appropriate CD patients for inclusion in therapeutic intervention trials.
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An Overview of Magnetic Resonance Enterography for Crohn’s Disease
Digestive Diseases and Sciences, 2014Co-Authors: Suresh Pola, Cynthia Santillan, Barrett G. Levesque, Brian G. Feagan, William J. SandbornAbstract:Magnetic Resonance Enterography (MRE) is a relatively new imaging modality that has shown promise for diagnosing, staging, and monitoring Crohn’s disease (CD) and its complications while avoiding exposure to ionizing radiation. In addition to clinical implications, MRE has the potential to be used as an objective measure of disease activity for clinical trials. We provide the rationale for MRE, indications for its use, and an overview of the typical procedure and common findings for institutions who want to begin or refine the use of MRE for CD.
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an overview of Magnetic Resonance Enterography for crohn s disease
Digestive Diseases and Sciences, 2014Co-Authors: Suresh Pola, Cynthia Santillan, Barrett G. Levesque, Brian G. Feagan, William J. SandbornAbstract:Magnetic Resonance Enterography (MRE) is a relatively new imaging modality that has shown promise for diagnosing, staging, and monitoring Crohn’s disease (CD) and its complications while avoiding exposure to ionizing radiation. In addition to clinical implications, MRE has the potential to be used as an objective measure of disease activity for clinical trials. We provide the rationale for MRE, indications for its use, and an overview of the typical procedure and common findings for institutions who want to begin or refine the use of MRE for CD.
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cost effectiveness of computed tomographic Enterography compared to Magnetic Resonance Enterography in a simulated medicare population with crohn s disease
Gastroenterology, 2011Co-Authors: Barrett G. Levesque, William J. Sandborn, Lauren E Cipriano, Gregory S Zaric, Edward V LoftusAbstract:Background: We estimated the cost-effectiveness of evaluating small-bowel Crohn's disease with Magnetic Resonance Enterography (MRE) as an alternative to computed tomographic Enterography (CTE) in Medicare-eligible patients. We assessed the potential cancer risk averted by using MRE. Methods: We developed a Markov model to compare the lifetime costs, benefits (measured in quality-adjusted life-years [QALYs] and cancers averted) and cost-effectiveness of using MRE rather than CTE for routine disease monitoring in a hypothetical cohort of 100,000 patients with Crohn's disease beginning at age 65. We assumed each CT-radiation exposure conferred an incremental annual risk of developing cancer using the linear, no-threshold model. We varied scan frequency, dose equivalent per scan, and risk of cancer per dose equivalent of exposure. Results: In the base case, using MRE instead of CTE every 5 years until age 85 has an incremental cost-effectiveness ratio (ICER) of $1,458,000/QALY. Two hundred ninety-five additional cancers in the simulated cohort were averted by using MRE alone. High-frequency scanning with two MRE scans per year up to age 85 resulted in an ICER of $1,112,000/QALY. In sensitivity analyses, only if the cost of MRE were less than $200 more than CTE, testing with MRE until age 70 would be costeffective, with an ICER of $75,000. Results were not sensitive to either patients' previous number of CTEs prior to age 65 or the effective dose (up to 24 mSv per CTE) per scan. Conclusions: MRE is not a cost-effective alternative to CTE among patients in this simulated population with Crohn's disease.
Shankar Kumar - One of the best experts on this subject based on the ideXlab platform.
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comparison of small intestinal contrast ultrasound with Magnetic Resonance Enterography in pediatric crohn s disease
Journal of Gastroenterology and Hepatology, 2020Co-Authors: Aishah Hakim, Christopher Alexakis, James Pilcher, Demitrios Tzias, Sally G Mitton, Thankam Paul, Sonia Saxena, R Pollok, Shankar KumarAbstract: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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small intestinal contrast ultrasonography for the detection of small bowel complications in crohn s disease correlation with intraoperative findings and Magnetic Resonance Enterography
Journal of Gastroenterology and Hepatology, 2015Co-Authors: Shankar Kumar, Aishah Hakim, Christopher Alexakis, James Pilcher, Demitrios Tzias, V Chhaya, Johnny Vlahos, R PollokAbstract:Background and Aims In evaluating small bowel Crohn's disease (CD), small intestine contrast-enhanced ultrasonography (SICUS) is emerging as an alternative to Magnetic Resonance Enterography (MRE). This retrospective study compared the diagnostic accuracy of SICUS and MRE with surgical findings, and their level of agreement. Methods We identified a cohort of CD patients investigated by either SICUS and/or MRE that subsequently required resective bowel surgery within 6 months. The accuracy and agreement of SICUS and MRE to detect small bowel complications were compared with intraoperative findings using kappa coefficient (κ). Agreement between SICUS and MRE in those undergoing both modalities was also assessed. Results A total of 67 patients were evaluated; 25 underwent SICUS and 17 underwent MRE prior to surgery. Another 25 patients underwent both SICUS and MRE. When compared with intraoperative findings, the sensitivity of SICUS and MRE was 87.5% and 100%, respectively, in detecting strictures, 87.7% and 66.7% for fistulae, 100% for both in identifying abscesses, 100% and 66.7% for bowel dilatation, and 94.7% and 81.8% in defining bowel wall thickening. When correlating SICUS and MRE with surgery, there was a high level of agreement in localizing strictures (κ = 0.75, 0.88, respectively), fistulae (κ = 0.82, 0.79) and abscesses (κ = 0.87, 0.77). Concordance between SICUS and MRE was substantial or almost complete in identifying stricturing disease (κ = 0.84), their number and location (κ = 0.85), fistulae (κ = 0.65), and mucosal thickening (κ = 0.61). Conclusion SICUS accurately identified small bowel complications and correlated well with MRE and intraoperative findings. SICUS offers an alternative in the preoperative assessment of CD.