Contrast enhanced ultrasound: comparing a novel modality to MRI to assess for bowel disease in pediatric Crohn's patients.
Contrast enhanced ultrasound (CEUS)
contrast ultrasound
imaging
inflammatory bowel disease
pediatric Crohn’s disease (pediatric CD)
Journal
Translational gastroenterology and hepatology
ISSN: 2415-1289
Titre abrégé: Transl Gastroenterol Hepatol
Pays: China
ID NLM: 101683450
Informations de publication
Date de publication:
2020
2020
Historique:
received:
26
06
2019
accepted:
23
10
2019
entrez:
8
4
2020
pubmed:
8
4
2020
medline:
8
4
2020
Statut:
epublish
Résumé
To demonstrate the feasibility and reliability of a novel imaging modality, contrast enhanced ultrasound (CEUS), in evaluating for distal small bowel inflammation in pediatric Crohn's disease (CD), and compare this to concurrently obtained magnetic resonance imaging (MRI) findings. Pediatric patients diagnosed with or having suspicion of CD with small bowel involvement, whose disease merited imaging with an MRI, concurrently underwent imaging with CEUS. We assessed the ability of CEUS to demonstrate distal small bowel disease by evaluating wall thickness, enhancement pattern, mucosal disruption and pericolonic inflammation. Concordance between imaging modalities was then assessed. Twenty patients were recruited for the study, 16 with known CD, 3 with concern for CD, and one with known colitis, but unknown bowel disease status. Six patients (3 with prior diagnosis of CD, 3 without) had absence of bowel enhancement on both ultrasound and MRI. Eleven patients with findings of inflammation and enhancement on MRI also had concurrent evidence of enhancement on CEUS. Three patients who had no evidence of inflammation on MRI, with known CD, had prominent bowel enhancement on CEUS. One patient with known colitis, whom we enrolled to evaluate for small bowel disease, had no evidence on either MRI or CEUS, however CEUS showed significant fat stranding around the colon, supporting the diagnosis of CD. The sensitivity of CEUS to detect bowel inflammation when seen on MRI was 100%. In addition, CEUS may also have the ability to detect bowel inflammation, even in the presence of a normal MRI.
Sections du résumé
BACKGROUND
BACKGROUND
To demonstrate the feasibility and reliability of a novel imaging modality, contrast enhanced ultrasound (CEUS), in evaluating for distal small bowel inflammation in pediatric Crohn's disease (CD), and compare this to concurrently obtained magnetic resonance imaging (MRI) findings.
METHODS
METHODS
Pediatric patients diagnosed with or having suspicion of CD with small bowel involvement, whose disease merited imaging with an MRI, concurrently underwent imaging with CEUS. We assessed the ability of CEUS to demonstrate distal small bowel disease by evaluating wall thickness, enhancement pattern, mucosal disruption and pericolonic inflammation. Concordance between imaging modalities was then assessed.
RESULTS
RESULTS
Twenty patients were recruited for the study, 16 with known CD, 3 with concern for CD, and one with known colitis, but unknown bowel disease status. Six patients (3 with prior diagnosis of CD, 3 without) had absence of bowel enhancement on both ultrasound and MRI. Eleven patients with findings of inflammation and enhancement on MRI also had concurrent evidence of enhancement on CEUS. Three patients who had no evidence of inflammation on MRI, with known CD, had prominent bowel enhancement on CEUS. One patient with known colitis, whom we enrolled to evaluate for small bowel disease, had no evidence on either MRI or CEUS, however CEUS showed significant fat stranding around the colon, supporting the diagnosis of CD.
CONCLUSIONS
CONCLUSIONS
The sensitivity of CEUS to detect bowel inflammation when seen on MRI was 100%. In addition, CEUS may also have the ability to detect bowel inflammation, even in the presence of a normal MRI.
Identifiants
pubmed: 32258517
doi: 10.21037/tgh.2019.11.02
pii: tgh-05-2019.11.02
pmc: PMC7063494
doi:
Types de publication
Journal Article
Langues
eng
Pagination
13Informations de copyright
2020 Translational Gastroenterology and Hepatology. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: The authors have no conflicts of interest to declare.
Références
AJR Am J Roentgenol. 2017 Feb;208(2):446-452
pubmed: 27959665
Ultrasound Int Open. 2017 Feb;3(1):E13-E24
pubmed: 28286879
J Magn Reson Imaging. 2017 Jun;45(6):1573-1588
pubmed: 27943484
Ultrasound Med Biol. 2017 Apr;43(4):725-734
pubmed: 28185694
Inflamm Bowel Dis. 2004 Jul;10(4):452-61
pubmed: 15475759
PLoS One. 2015 Aug 31;10(8):e0136105
pubmed: 26322970
Abdom Imaging. 2008 Jul-Aug;33(4):407-16
pubmed: 17619923
AJR Am J Roentgenol. 2014 May;202(5):966-70
pubmed: 24758648
J Magn Reson Imaging. 2011 Mar;33(3):527-34
pubmed: 21512607