BACKGROUND: Children with inflammatory bowel disease (IBD) undergo invasive and repeated investigations, including contrast radiology and endoscopy. OBJECTIVE: To assess transabdominal sonography of the colon and distal ileum compared to colonoscopy and barium radiology in known or suspected IBD. MATERIALS AND METHODS: A prospectively recruited cohort of 44 children (median age 12 years, range 3.5-16.5 years; 24 males) underwent transabdominal sonography prior to colonoscopy (n=33) or barium follow-through (n=25). Diagnoses were: Crohn disease (n=25), ulcerative colitis (n=12), indeterminate colitis (n=1), normal (n=6). RESULTS: Bowel wall thickness (BWT) and endoscopic severity were compared in 153 colonic segments. No difference was found between normal and mildly affected segments. BWT was less in normal bowel than moderate (P<0.001) or severe (P<0.001) lesions. Where BWT was >2.9 mm, sensitivity for moderate/severe disease was 48%, specificity 93%, positive predictive value 83% (likelihood ratio 7). Barium radiology showed terminal ileum abnormality in ten patients (40%). Where ileal BWT was >2.5 mm, comparative sensitivity was 75%, specificity 92%, positive predictive value 88% (likelihood ratio 9). Superior mesenteric artery Doppler did not correlate with disease severity. CONCLUSION: Increased BWT has good positive predictive value for moderate/severe disease in the colon proximal to the rectum (>3 mm), and terminal ileum (>2.5 mm). BWT below this cannot exclude moderate/severe mucosal lesions.
BACKGROUND:Children with inflammatory bowel disease (IBD) undergo invasive and repeated investigations, including contrast radiology and endoscopy. OBJECTIVE: To assess transabdominal sonography of the colon and distal ileum compared to colonoscopy and barium radiology in known or suspected IBD. MATERIALS AND METHODS: A prospectively recruited cohort of 44 children (median age 12 years, range 3.5-16.5 years; 24 males) underwent transabdominal sonography prior to colonoscopy (n=33) or barium follow-through (n=25). Diagnoses were: Crohn disease (n=25), ulcerative colitis (n=12), indeterminate colitis (n=1), normal (n=6). RESULTS: Bowel wall thickness (BWT) and endoscopic severity were compared in 153 colonic segments. No difference was found between normal and mildly affected segments. BWT was less in normal bowel than moderate (P<0.001) or severe (P<0.001) lesions. Where BWT was >2.9 mm, sensitivity for moderate/severe disease was 48%, specificity 93%, positive predictive value 83% (likelihood ratio 7). Barium radiology showed terminal ileum abnormality in ten patients (40%). Where ileal BWT was >2.5 mm, comparative sensitivity was 75%, specificity 92%, positive predictive value 88% (likelihood ratio 9). Superior mesenteric artery Doppler did not correlate with disease severity. CONCLUSION: Increased BWT has good positive predictive value for moderate/severe disease in the colon proximal to the rectum (>3 mm), and terminal ileum (>2.5 mm). BWT below this cannot exclude moderate/severe mucosal lesions.
Authors: Antonio Rispo; Massimo Imbriaco; Luigi Celentano; Antonio Cozzolino; Luigi Camera; Pier P Mainenti; Francesco Manguso; Francesco Sabbatini; Patrizia D'Amico; Fabiana Castiglione Journal: Inflamm Bowel Dis Date: 2005-04 Impact factor: 5.325
Authors: S Hollerbach; A Geissler; H Schiegl; F Kullmann; G Lock; J Schmidt; J Schlegel; J Schoelmerich; T Andus Journal: Scand J Gastroenterol Date: 1998-11 Impact factor: 2.423
Authors: Giovanni Maconi; Gianluca M Sampietro; Fabrizio Parente; Giovanni Pompili; Antonio Russo; Massimo Cristaldi; Giancarlo Arborio; Sandro Ardizzone; Giovanni Matacena; Angelo Maria Taschieri; Gabriele Bianchi Porro Journal: Am J Gastroenterol Date: 2003-07 Impact factor: 10.864
Authors: Jonathan R Dillman; Ethan A Smith; Ramon Sanchez; Michael A DiPietro; Soudabeh Fazeli Dehkordy; Jeremy Adler; Vera DeMatos-Maillard; Shokoufeh Khalatbari; Matthew S Davenport Journal: Pediatr Radiol Date: 2015-12-30
Authors: Jonathan R Dillman; Ethan A Smith; Ramon J Sanchez; Michael A DiPietro; Vera DeMatos-Maillard; Peter J Strouse; Kassa Darge Journal: Radiographics Date: 2015-04-03 Impact factor: 5.333
Authors: Timothy L Tsai; Megan B Marine; Matthew R Wanner; Matthew L Cooper; Steven J Steiner; Fangqian Ouyang; S Gregory Jennings; Boaz Karmazyn Journal: Pediatr Radiol Date: 2017-04-22