Purpose: Intestinal ultrasound (IUS) is widely used as the first exam in patients with suspected inflammatory bowel disease (IBD). This study investigated the accuracy of several IUS parameters, including increased bowel wall thickening (BWT), in detecting IBD in a paediatric population. Methods: The study included an unselected series of 113 patients aged 2–18 years (mean age 10.8 years, 65 male), referred for recurrent abdominal pain or altered bowel habits, without known organic diseases, to perform an IUS as first investigation of a diagnostic workup. Patients with full systematic IUS examination, clinical and biochemical exams, and ileocolonoscopy or an uneventful follow-up at least one year follow up were eligible. Results: 23 IBD patients (20.4%; 8 ulcerative colitis, 12 Crohn’s disease and 3 indeterminate colitis) were diagnosed. We found that increased BWT > 3 mm (OR 5.4), altered IUS bowel pattern (IUS-BP, OR 9.8) and mesenteric hypertrophy (MH, OR 5.2) accurately identified IBD at the multivariate analysis. IUS-BP, MH and BWT > 3 mm had a sensitivity of 78.3%, 65.2% and 69.6% and a specificity of 93.3%, 92.2% and 96.7%, respectively. The combination of these three alterations increased the specificity up to 100%, whilst decreased sensitivity to 56.5%. Conclusion: Among several US parameters suggestive of IBD, the increased BWT, MH and altered echopattern are independent predictors of IBD. The ultrasonographic diagnosis of IBD could be more accurate if relied on combination of different sonographic parameters, than on the sole BWT evaluation.

Relevance of sonographic parameters for inflammatory bowel disease in children / A. Dell'Era, R. Cannatelli, F. Ferretti, C. Manzotti, D. Dilillo, G. Zuccotti, F. Meneghin, S. Ardizzone, G. Maconi. - In: JOURNAL OF ULTRASOUND. - ISSN 1971-3495. - (2023), pp. 1-8. [Epub ahead of print] [10.1007/s40477-023-00800-9]

Relevance of sonographic parameters for inflammatory bowel disease in children

A. Dell'Era
Primo
Formal Analysis
;
C. Manzotti
Writing – Review & Editing
;
G. Zuccotti
Writing – Review & Editing
;
S. Ardizzone
Writing – Review & Editing
;
G. Maconi
Ultimo
Writing – Original Draft Preparation
2023

Abstract

Purpose: Intestinal ultrasound (IUS) is widely used as the first exam in patients with suspected inflammatory bowel disease (IBD). This study investigated the accuracy of several IUS parameters, including increased bowel wall thickening (BWT), in detecting IBD in a paediatric population. Methods: The study included an unselected series of 113 patients aged 2–18 years (mean age 10.8 years, 65 male), referred for recurrent abdominal pain or altered bowel habits, without known organic diseases, to perform an IUS as first investigation of a diagnostic workup. Patients with full systematic IUS examination, clinical and biochemical exams, and ileocolonoscopy or an uneventful follow-up at least one year follow up were eligible. Results: 23 IBD patients (20.4%; 8 ulcerative colitis, 12 Crohn’s disease and 3 indeterminate colitis) were diagnosed. We found that increased BWT > 3 mm (OR 5.4), altered IUS bowel pattern (IUS-BP, OR 9.8) and mesenteric hypertrophy (MH, OR 5.2) accurately identified IBD at the multivariate analysis. IUS-BP, MH and BWT > 3 mm had a sensitivity of 78.3%, 65.2% and 69.6% and a specificity of 93.3%, 92.2% and 96.7%, respectively. The combination of these three alterations increased the specificity up to 100%, whilst decreased sensitivity to 56.5%. Conclusion: Among several US parameters suggestive of IBD, the increased BWT, MH and altered echopattern are independent predictors of IBD. The ultrasonographic diagnosis of IBD could be more accurate if relied on combination of different sonographic parameters, than on the sole BWT evaluation.
Bowel wall thickness; Children; Fecal calprotectin; Inflammatory bowel diseases; Intestinal ultrasound; Ultrasound;
Settore MED/12 - Gastroenterologia
Settore MED/38 - Pediatria Generale e Specialistica
Settore MED/36 - Diagnostica per Immagini e Radioterapia
2023
4-lug-2023
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1005488
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