Fulvia Terracciano1, Giuseppe Scalisi2, Fabrizio Bossa3, Daniela Scimeca4, Giuseppe Biscaglia5, Michele Mangiacotti6, Maria Rosa Valvano7, Francesco Perri8, Anna Simeone9, Angelo Andriulli10. 1. Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: terracciano74@hotmail.it. 2. Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: scalisi.giuseppe@alice.it. 3. Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: f.bossa@operapadrepio.it. 4. Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: danisci@hotmail.com. 5. Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: giuseppe.biscaglia@gmail.it. 6. Radiology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: mimangia2@gmail.com. 7. Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: mr.valvano@operapadrepio.it. 8. Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: f.perri@operapadrepio.it. 9. Radiology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: a.simeone@operapadrepio.it. 10. Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: a.andriulli@operapadrepio.it.
Abstract
BACKGROUND: A pelvic magnetic resonance imaging (MRI) represents the front-line method for evaluating perianal disease in patients with inflammatory bowel disease (IBD). Recently, transperineal ultrasonography (TPUS) has been proposed as a simple, safe, time-sparing and useful diagnostic technique to assess different pathological conditions of the pelvic floor. AIM: The aim of this prospective single centre study was to evaluate the accuracy of TPUS versus MRI for the detection and classification of perineal disease in IBD patients. METHODS: From November 2013 to November 2014, 28 IBD patients underwent either TPUS or MRI. Fistulae and abscesses were classified according to Parks' and AGA's classification methods. A concordance was assessed by k statistics. RESULTS: Overall, 33 fistulae and 8 abscesses were recognized by TPUS (30 and 7 by MRI, respectively). The agreement between TPUS and MRI was 75% according to Parks' classification (k=0.67) and 86% according to AGA classification (k=0.83), while it was 36% (k=0.34) for classifying abscesses. CONCLUSIONS: TPUS proved to be as accurate as MRI for detecting superficial and small abscesses and for classifying perianal disease. Both examinations may be performed at the initial presentation of the patient, but TPUS is a cheaper, time-sparing procedure. The optimal use of TPUS might be in follow-up patients.
BACKGROUND: A pelvic magnetic resonance imaging (MRI) represents the front-line method for evaluating perianal disease in patients with inflammatory bowel disease (IBD). Recently, transperineal ultrasonography (TPUS) has been proposed as a simple, safe, time-sparing and useful diagnostic technique to assess different pathological conditions of the pelvic floor. AIM: The aim of this prospective single centre study was to evaluate the accuracy of TPUS versus MRI for the detection and classification of perineal disease in IBDpatients. METHODS: From November 2013 to November 2014, 28 IBDpatients underwent either TPUS or MRI. Fistulae and abscesses were classified according to Parks' and AGA's classification methods. A concordance was assessed by k statistics. RESULTS: Overall, 33 fistulae and 8 abscesses were recognized by TPUS (30 and 7 by MRI, respectively). The agreement between TPUS and MRI was 75% according to Parks' classification (k=0.67) and 86% according to AGA classification (k=0.83), while it was 36% (k=0.34) for classifying abscesses. CONCLUSIONS: TPUS proved to be as accurate as MRI for detecting superficial and small abscesses and for classifying perianal disease. Both examinations may be performed at the initial presentation of the patient, but TPUS is a cheaper, time-sparing procedure. The optimal use of TPUS might be in follow-up patients.
Authors: Dieter Nuernberg; Adrian Saftoiu; Ana Paula Barreiros; Eike Burmester; Elena Tatiana Ivan; Dirk-André Clevert; Christoph F Dietrich; Odd Helge Gilja; Torben Lorentzen; Giovanni Maconi; Ismail Mihmanli; Christian Pallson Nolsoe; Frank Pfeffer; Søren Rafael Rafaelsen; Zeno Sparchez; Peter Vilmann; Jo Erling Riise Waage Journal: Ultrasound Int Open Date: 2019-02-05