Abdominal ultrasonography with color Doppler analysis in the assessment of ileal Crohn’s disease: comparison with magnetic resonance enterography

• Published in: Intestinal research Vol. 17; no. 2; pp. 227 - 236
• Main Authors: da Silva Moraes, Antonio Carlos, de Freitas Moraes, Glycia, de Araújo, Antonio Luis Eiras, Luiz, Ronir Raggio, Elia, Celeste, Carneiro, Antonio Jose, de Souza, Heitor Siffert Pereira
• Format: Journal Article
• Language: English
• Published: Korean Association for the Study of Intestinal Diseases 01-04-2019; 대한장연구학회
• Subjects: Calprotectin; Color Doppler ultrasonography; Crohn disease; Ileitis; Magnetic resonance imaging; Original; 내과학
• ISSN: 1598-9100; 2288-1956
• DOI: 10.5217/ir.2018.00124

Background/Aims Consistently defining disease activity remains a critical challenge in the follow-up of patients with Crohn’s disease (CD). We investigated the potential applicability of abdominal ultrasonography with color Doppler (USCD) analysis for the detection of morphological alterations and inflammatory activity in CD. Methods Forty-three patients with CD ileitis/ileocolitis were evaluated using USCD analysis with measurements obtained on the terminal ileum and right colon. Sonographic parameters included wall thickening, stricture, hyperemia, presence of intra-abdominal mass, and fistulas. Patients were evaluated for the clinical activity (Harvey-Bradshaw Index [HBI]), fecal calprotectin (FC) and C-reactive protein (CRP). The USCD performance was assessed using magnetic resonance enterography (MRE) as a criterion standard. Results Most measurements obtained with USCD matched the data generated with MRE; however, the agreement improved in clinically active patients where sensitivity, positive predictive value, and accuracy were >80%, considering wall thickening and hyperemia. Complications such as intestinal wall thickening, stricture formation, and hyperemia, were detected in the USCD analysis with moderate agreement with MRE. The best agreement with the USCD analysis was obtained in regard to FC, where the sensitivity, positive predictive value, and accuracy were >70%. The overall performance of USCD was superior to that of HBI, FC and CRP levels, particularly when considering thickening, stricture, and hyperemia parameters. Conclusions USCD represents a practical noninvasive and low-cost tool for evaluating patients with ileal or ileocolonic disease, particularly in clinically active CD. Therefore, USCD might become a useful asset in the follow-up of patients with CD.