US Capable of Evaluating Extent of Crohn’s Disease
A study published in the journal Abdominal Imaging indicates that ultrasound is as effective as contrast MRI in determining the extent of Crohn’s disease. Researchers in Spain recruited a sample of thirty patients who all had a histopathologic diagnosis of Crohn’s disease. Patients underwent imaging with both MRI and ultrasound on the same day.
Ultrasound studies were completed first. Assessment considered five distinct segments of the gastrointestinal tract to examine thickness of the bowel wall, perienteric changes, and vascularity pattern. Following completion, patients then received the contrast agent used for MRI assessment. In reviewing MRI studies, radiologists considered bowel wall enhancement, perienteric changes, and bowel wall thickness.
The researchers considered findings from the imaging studies compared to the current gold standard in diagnostic testing for Crohn’s disease. Tests for comparison include surgery, colonoscopy, and barium studies among other laboratory and clinical tests. Data from these gold standard studies indicates that 45 percent of the 119 bowel segment examined had pathologic changes associated with Crohn’s disease.
Findings from ultrasound examination were superior in identifying localized affected bowel segment. The sensitivity with this modality was 91 percent, compared to 83 percent sensitivity with MRI. Ultrasound was also better at detecting transmural complications with a sensitivity of 80 percent. The sensitivity of MRI for such was 72 percent, though these findings were not statistically significant.
Findings from the studies that were found to be statistically significant include the correlation between MRI bowel wall enhancement and color Doppler flow. Findings were significant for both per-patient and segment-by-segment analysis.
Perienteric changes found with MRI and ultrasound were also correlated.
The research team noted that both imaging modalities provide information about the bowel segments affected by the condition. MRI and ultrasound were also able to assess complications of the bowel wall.
March 11, 2008 Related topics: Imaging, Diagnostic, Gastroenterology