Comparison of small intestinal contrast ultrasound with magnetic resonance enterography in paediatric Crohn’s disease

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Title: Comparison of small intestinal contrast ultrasound with magnetic resonance enterography in paediatric Crohn’s disease
Authors: Saxena, S
Hakim, A
Alexakis, C
Pilcher, J
Tzias, D
Mitton, S
Paul, T
Pollok, R
Kumar, S
Item Type: Journal Article
Abstract: Aim To compare the diagnostic yield of small intestinal contrast ultrasonography (SICUS) with magnetic resonance enterography (MRE) in routine clinical practice in a cohort of paediatric patients investigated for Crohn’s disease (CD) attending a UK tertiary centre. Methods and results Patients with suspected or established CD who underwent SICUS were identified retrospectively. SICUS was compared to conventional trans-abdominal ultrasound (TUS), ileocolonoscopy (IC) and MRE. Accuracy and agreement of SICUS in detecting small bowel lesions and CD-related complications were assessed using kappa (κ) coefficient statistics. Ninety-three patients (median age 15 years, range 2–17, 49 male) underwent SICUS; 58 had suspected and 35 established CD. In suspected CD, sensitivity and specificity of SICUS in detecting CD small bowel lesions were 81.8% and 100% and for trans-abdominal ultrasound (TUS) 85.7% and 87.5%, respectively. In established CD, sensitivity and specificity of SICUS were 98.7% and 100% and TUS 80% and 100%, respectively. Agreement between SICUS and IC was substantial for the presence of lesions (κ=0.73) but fair with TUS (κ=0.31). Agreement between SICUS and IC was almost perfect for detecting strictures (κ=0.84) with a sensitivity of 100% and specificity of 97.6%. When comparing SICUS and TUS with MRE, agreement for the presence of lesions was substantial (κ=0.63) and moderate (κ=0.53) respectively. Agreement between SICUS and MRE was substantial for detecting strictures (κ=0.77) and dilatation (κ=0.68). Conclusions SICUS offers a radiation-free alternative for assessing paediatric small bowel CD, with diagnostic accuracy that is comparable to MRE and IC, supporting its wider use in routine practice.
Date of Acceptance: 30-Jun-2019
URI: http://hdl.handle.net/10044/1/71757
ISSN: 2397-9070
Publisher: Wiley
Journal / Book Title: JGH Open
Publication Status: Accepted
Embargo Date: Embargoed for 12 months after publication date
Appears in Collections:Epidemiology, Public Health and Primary Care



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