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Ultrasonography of Crohn disease in children

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Abstract

US is increasingly performed in Crohn disease (CD) in children as a first line imaging modality. It reduces the use of other more invasive examinations such as endoscopy, CT or contrast enema. We describe bowel ultrasonography technique, normal bowel appearances on US and pathological patterns in CD. We discuss the current role and limitations of bowel US in CD in children including diagnosis, extent of disease, assessment of disease activity, follow-up and detection of complications. The diagnostic accuracy of US is discussed according to the literature and compared to other imaging modalities. US is currently used for screening in children with the suspicion of inflammatory bowel disease (IBD) with a good negative predictive value. In follow-up, US has a role in monitoring medical treatment by evaluating disease activity, extent of disease and for detecting complications.

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References

  1. Kim SC, Ferry GD (2004) Inflammatory bowel diseases in paediatric and adolescent patients: clinical, therapeutic, and psychosocial considerations. Gastroenterology 126:1550–1560

    Article  PubMed  Google Scholar 

  2. Schmidt T, Hohl C, Haage P et al (2005) Phase-inversion tissue harmonic imaging compared to fundamental B-mode ultrasound in the evaluation of the pathology of large and small bowel. Eur Radiol 15:2021–2030

    Article  PubMed  CAS  Google Scholar 

  3. Tarjan Z, Toth G, Gyorke T et al (2000) Ultrasound in Crohn’s disease of the small bowel. Eur J Radiol 35:176–182

    Article  PubMed  CAS  Google Scholar 

  4. Kimmey MB, Martin RW, Haggitt RC et al (1989) Histologic correlates of gastrointestinal ultrasound images. Gastroenterology 96:433–441

    PubMed  CAS  Google Scholar 

  5. Valette PJ, Rioux M, Pilleul F et al (2001) Ultrasonography of chronic inflammatory bowel diseases. Eur Radiol 11:1859–1866

    Article  PubMed  CAS  Google Scholar 

  6. Faure C, Belarbi N, Mougenot JF et al (1997) Ultrasonographic assessment of inflammatory bowel disease in children: comparison with ileocolonoscopy. J Pediatr 130:147–151

    Article  PubMed  CAS  Google Scholar 

  7. Haber HP, Busch A, Ziebach R et al (2002) Ultrasonographic findings correspond to clinical, endoscopic, and histologic findings in inflammatory bowel disease and other enterocolitides. J Ultrasound Med 21:375–382

    PubMed  Google Scholar 

  8. Auvin S, Molinie F, Gower Rousseau C et al (2005) Incidence, clinical presentation and location at diagnosis of pediatric inflammatory bowel disease: a prospective population based study in Northern France (1988–199). J Pediatr Gastroenterol Nutr 41: 49–55

    Google Scholar 

  9. Dinkel E, Dittrich M, Peters H et al (1986) Real-time ultrasound in Crohn’s disease: characteristic features and clinical implications. Pediatr Radiol 16:8–12

    Article  PubMed  CAS  Google Scholar 

  10. Fraquelli M, Colli A, Casazza G et al (2005) Role of US in detection of Crohn disease: meta-analysis. Radiology 236:95–101

    Article  PubMed  Google Scholar 

  11. Canani RB, de Horatio LT, Terrin G et al (2006) Combined use of noninvasive tests is useful in the initial diagnostic approach to a child with suspected inflammatory bowel disease. J Pediatr Gastroenterol Nutr 42:9–15

    Article  PubMed  Google Scholar 

  12. Borthne AS, Abdelnoor M, Rugtveit J et al (2006) Bowel magnetic resonance imaging of pediatric patients with oral mannitol MRI compared to endoscopy and intestinal ultrasound. Eur Radiol 16:207–214

    Article  PubMed  Google Scholar 

  13. Bremner AR, Pridgeon J, Fairhurst J et al (2004) Ultrasound scanning may reduce the need for barium radiology in the assessment of small-bowel Crohn’s disease. Acta Paediatr 93:479–481

    Article  PubMed  CAS  Google Scholar 

  14. Ripolles T, Martinez MJ, Morote V et al (2006) Appendiceal involvement in Crohn’s disease: gray-scale sonography and color Doppler flow features. AJR 186:1071–1078

    Article  PubMed  Google Scholar 

  15. Calabrese E, La Seta F, Buccellato A et al (2005) Crohn’s disease: a comparative prospective study of transabdominal ultrasonography, small intestine contrast ultrasonography, and small bowel enema. Inflamm Bowel Dis 11:139–145

    Article  PubMed  Google Scholar 

  16. Pallotta N, Tomei E, Viscido A et al (2005) Small intestine contrast ultrasonography: an alternative to radiology in the assessment of small bowel disease. Inflamm Bowel Dis 11:146–153

    Article  PubMed  Google Scholar 

  17. Parente F, Greco S, Molteni M et al (2004) Oral contrast enhanced bowel ultrasonography in the assessment of small intestine Crohn’s disease. A prospective comparison with conventional ultrasound, x ray studies, and ileocolonoscopy. Gut 53:1652–1657

    Article  PubMed  CAS  Google Scholar 

  18. Parente F, Greco S, Molteni M et al (2003) Role of early ultrasound in detecting inflammatory intestinal disorders and identifying their anatomical location within the bowel. Aliment Pharmacol Ther 18:1009–1016

    Article  PubMed  CAS  Google Scholar 

  19. Potthast S, Rieber A, Von Tirpitz C et al (2002) Ultrasound and magnetic resonance imaging in Crohn’s disease: a comparison. Eur Radiol 12:1416–1422

    Article  PubMed  CAS  Google Scholar 

  20. Haber HP, Busch A, Ziebach R et al (2000) Bowel wall thickness measured by ultrasound as a marker of Crohn’s disease activity in children. Lancet 355:1239–1240

    Article  PubMed  CAS  Google Scholar 

  21. Ruess L, Blask AR, Bulas DI et al (2000) Inflammatory bowel disease in children and young adults: correlation of sonographic and clinical parameters during treatment. AJR 175:79–84

    PubMed  CAS  Google Scholar 

  22. Spalinger J, Patriquin H, Miron MC et al (2000) Doppler US in patients with Crohn disease: vessel density in the diseased bowel reflects disease activity. Radiology 217:787–791

    PubMed  CAS  Google Scholar 

  23. Yekeler E, Danalioglu A, Movasseghi B et al (2005) Crohn disease activity evaluated by Doppler ultrasonography of the superior mesenteric artery and the affected small-bowel segments. J Ultrasound Med 24:59–65

    PubMed  Google Scholar 

  24. Miao YM, Koh DM, Amin Z et al (2002) Ultrasound and magnetic resonance imaging assessment of active bowel segments in Crohn’s disease. Clin Radiol 57:913–918

    Article  PubMed  CAS  Google Scholar 

  25. van Oostayen JA, Wasser MN, van Hogezand RA et al (1997) Doppler sonography evaluation of superior mesenteric artery flow to assess Crohn’s disease activity: correlation with clinical evaluation, Crohn’s disease activity index, and alpha 1-antitrypsin clearance in feces. AJR 168:429–433

    PubMed  Google Scholar 

  26. Scholbach T, Herrero I, Scholbach J (2004) Dynamic color Doppler sonography of intestinal wall in patients with Crohn disease compared with healthy subjects. J Pediatr Gastroenterol Nutr 39:524–528

    Article  PubMed  Google Scholar 

  27. Robotti D, Cammarota T, Debani P et al (2004) Activity of Crohn disease: value of Color-Power-Doppler and contrast-enhanced ultrasonography. Abdom Imaging 29:648–652

    Article  PubMed  CAS  Google Scholar 

  28. Di Sabatino A, Fulle I, Ciccocioppo R et al (2002) Doppler enhancement after intravenous levovist injection in Crohn’s disease. Inflamm Bowel Dis 8:251–257

    Article  PubMed  Google Scholar 

  29. Rapaccini GL, Pompili M, Orefice R et al (2004) Contrast-enhanced power doppler of the intestinal wall in the evaluation of patients with Crohn disease. Scand J Gastroenterol 39:188–194

    Article  PubMed  CAS  Google Scholar 

  30. Castiglione F, de Sio I, Cozzolino A et al (2004) Bowel wall thickness at abdominal ultrasound and the one-year-risk of surgery in patients with Crohn’s disease. Am J Gastroenterol 99:1977–1983

    Article  PubMed  Google Scholar 

  31. Hirche TO, Russler J, Schroder O et al (2002) The value of routinely performed ultrasonography in patients with Crohn disease. Scand J Gastroenterol 37:1178–1183

    Article  PubMed  CAS  Google Scholar 

  32. Maconi G, Sampietro GM, Cristaldi M et al (2001) Preoperative characteristics and postoperative behavior of bowel wall on risk of recurrence after conservative surgery in Crohn’s disease: a prospective study. Ann Surg 233:345–352

    Article  PubMed  CAS  Google Scholar 

  33. DiCandio G, Mosca F, Campatelli A et al (1986) Sonographic detection of postsurgical recurrence of Crohn disease. AJR 146:523–526

    PubMed  CAS  Google Scholar 

  34. Andreoli A, Cerro P, Falasco G et al (1998) Role of ultrasonography in the diagnosis of postsurgical recurrence of Crohn’s disease. Am J Gastroenterol 93:1117–1121

    Article  PubMed  CAS  Google Scholar 

  35. Maconi G, Bollani S, Bianchi Porro G (1996) Ultrasonographic detection of intestinal complications in Crohn’s disease. Dig Dis Sci 41:1643–1648

    Article  PubMed  CAS  Google Scholar 

  36. Maconi G, Radice E, Greco S et al (2006) Bowel ultrasound in Crohn’s disease. Best Pract Res Clin Gastroenterol 20:93–112

    Article  PubMed  Google Scholar 

  37. Kratzer W, von Tirpitz C, Mason R et al (2002) Contrast-enhanced power Doppler sonography of the intestinal wall in the differentiation of hypervascularized and hypovascularized intestinal obstructions in patients with Crohn’s disease. J Ultrasound Med 21:149–157

    PubMed  Google Scholar 

  38. Gasche C, Moser G, Turetschek K et al (1999) Transabdominal bowel sonography for the detection of intestinal complications in Crohn’s disease. Gut 44:112–117

    Article  PubMed  CAS  Google Scholar 

  39. Maconi G, Sampietro GM, Parente F et al (2003) Contrast radiology, computed tomography and ultrasonography in detecting internal fistulas and intra-abdominal abscesses in Crohn’s disease: a prospective comparative study. Am J Gastroenterol 98:1545–1555

    Article  PubMed  Google Scholar 

  40. Esteban JM, Aleixandre A, Hurtado MJ et al (2003) Contrast-enhanced power Doppler ultrasound in the diagnosis and follow-up of inflammatory abdominal masses in Crohn’s disease. Eur J Gastroenterol Hepatol 15:253–259

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Paediatric Imaging, Hospital Robert Debré, Paris VII University, 48 Bd Serurier, Paris, 75019, France

    Marianne Alison, Ahmed Kheniche, Robin Azoulay, Sandrine Roche, Guy Sebag & Nadia Belarbi

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  1. Marianne Alison
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  2. Ahmed Kheniche
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  3. Robin Azoulay
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  4. Sandrine Roche
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  5. Guy Sebag
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  6. Nadia Belarbi
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Correspondence to Marianne Alison.

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Alison, M., Kheniche, A., Azoulay, R. et al. Ultrasonography of Crohn disease in children. Pediatr Radiol 37, 1071–1082 (2007). https://doi.org/10.1007/s00247-007-0559-1

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  • DOI: https://doi.org/10.1007/s00247-007-0559-1

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