OBJECTIVES: To evaluate the usefulness of colonic ultrasonography (US) in assessing the extent and activity of disease in pediatric ulcerative colitis (UC) and to compare US findings with clinical and endoscopic features. STUDY DESIGN: Consecutive pediatric patients (n = 60) with a diagnosis of UC and suspected disease flare-up were prospectively enrolled; of these, 50 patients were eligible for the study. All underwent clinical evaluation, bowel US with color Doppler examination and colonoscopy. Blind US was performed the day before endoscopy in all patients. The US assessed variables were bowel wall thickness >3 mm, bowel wall stratification, vascularity, presence of haustra coli, and enlarged mesenteric lymph nodes. RESULTS: The endoscopic extent of disease was independently confirmed in 47 patients by US that yielded a 90% concordance with endoscopy (95% CI 0.82-0.96). Multiple regression analysis showed that US measurements with an independent predictive value of severity at endoscopy were increased bowel wall thickness (P < .0008), increased vascularity (P < .002), loss of haustra (P = .031), and loss of stratification of the bowel wall (P = .021). Each variable was assigned a value of 1 if present. The US score strongly correlated with clinical (r = 0.94) and endoscopic activity (r = 0.90) of disease (P < .0001). CONCLUSIONS: Colonic US is a useful first line noninvasive tool to assess the extent and activity of disease in children with UC and to estimate the severity of a flare-up, prior to further invasive tests.
OBJECTIVES: To evaluate the usefulness of colonic ultrasonography (US) in assessing the extent and activity of disease in pediatric ulcerative colitis (UC) and to compare US findings with clinical and endoscopic features. STUDY DESIGN: Consecutive pediatric patients (n = 60) with a diagnosis of UC and suspected disease flare-up were prospectively enrolled; of these, 50 patients were eligible for the study. All underwent clinical evaluation, bowel US with color Doppler examination and colonoscopy. Blind US was performed the day before endoscopy in all patients. The US assessed variables were bowel wall thickness >3 mm, bowel wall stratification, vascularity, presence of haustra coli, and enlarged mesenteric lymph nodes. RESULTS: The endoscopic extent of disease was independently confirmed in 47 patients by US that yielded a 90% concordance with endoscopy (95% CI 0.82-0.96). Multiple regression analysis showed that US measurements with an independent predictive value of severity at endoscopy were increased bowel wall thickness (P < .0008), increased vascularity (P < .002), loss of haustra (P = .031), and loss of stratification of the bowel wall (P = .021). Each variable was assigned a value of 1 if present. The US score strongly correlated with clinical (r = 0.94) and endoscopic activity (r = 0.90) of disease (P < .0001). CONCLUSIONS: Colonic US is a useful first line noninvasive tool to assess the extent and activity of disease in children with UC and to estimate the severity of a flare-up, prior to further invasive tests.
Authors: Liliana Chiorean; Dagmar Schreiber-Dietrich; Barbara Braden; Xin-Wu Cui; Reiner Buchhorn; Jian-Min Chang; Christoph F Dietrich Journal: World J Gastroenterol Date: 2015-05-07 Impact factor: 5.742
Authors: Elsa A van Wassenaer; Floris A E de Voogd; Rick R van Rijn; Johanna H van Der Lee; Merit M Tabbers; Faridi S van Etten-Jamaludin; Krisztina B Gecse; Angelika Kindermann; Tim G J De Meij; Geert R D'haens; Marc A Benninga; Bart G P Koot Journal: J Crohns Colitis Date: 2019-12-10 Impact factor: 9.071
Authors: Christian Maaser; Frauke Petersen; Ulf Helwig; Imma Fischer; Alexander Roessler; Stefan Rath; Dorothee Lang; Torsten Kucharzik Journal: Gut Date: 2019-12-20 Impact factor: 23.059
Authors: Elsa A van Wassenaer; Floris A E de Voogd; Rick R van Rijn; Johanna H van der Lee; Merit M Tabbers; Faridi S van Etten-Jamaludin; Angelika Kindermann; Tim G J de Meij; K B Gecse; Geert R D'Haens; Marc A Benninga; Bart G P Koot Journal: Pediatr Radiol Date: 2019-12-14