title: Accuracy of small-intestine contrast ultrasonography, compared with computed tomography enteroclysis, in characterizing lesions in patients with Crohn's disease.
abstract: OBJECTIVE
  Small-intestine contrast ultrasonography (SICUS) is a radiation-free technique that can detect intestinal damage in patients with Crohn's disease (CD). We evaluated the diagnostic accuracy of SICUS in determining the site, extent, and complications of CD, compared with computed tomography (CT) enteroclysis as the standard.
  
  
  METHODS
  We performed a retrospective analysis of data from 59 patients with CD evaluated by SICUS and CT enteroclysis 3 months apart, between January 2007 and April 2012. We evaluated disease site (based on bowel wall thickness), extent of lesions, and presence of complications (stenosis, prestenotic dilation, abscess, or fistulas) using CT enteroclysis as the standard. Sensitivity, specificity, and diagnostic accuracy were calculated. We determined the correlations in maximum wall thickness and disease extent in the small bowel between results from SICUS and CT enteroclysis.
  
  
  RESULTS
  SICUS identified the site of small bowel CD with 98% sensitivity, 67% specificity, and 95% diagnostic accuracy; it identified the site of colon CD with 83% sensitivity, 97.5% specificity, and 93% diagnostic accuracy. Results from SICUS and CT enteroclysis correlated in determination of bowel wall thickness (rho, 0.79) and disease extent (rho, 0.89; P < .0001 for both). SICUS detected ileal stenosis with 95.5% sensitivity, 80% specificity, and 91.5% diagnostic accuracy, and prestenotic dilation with 87% sensitivity, 67% specificity, and 75% diagnostic accuracy. SICUS detected abscesses with 78% sensitivity, 100% specificity, and 97% diagnostic accuracy, and fistulas with 78.5% sensitivity, 95.5% specificity, and 91.5% diagnostic accuracy.
  
  
  CONCLUSIONS
  SICUS identified lesions and complications in patients with CD with high levels of sensitivity, specificity, and accuracy compared with CT enteroclysis. SICUS might be used as an imaging tool as part of a focused diagnostic examination of patients with CD.
authors: Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy. emma.calabrese@uniroma2.it
authors: Emma
authors: E
authors: Calabrese
authors: Francesca
authors: F
authors: Zorzi
authors: Sara
authors: S
authors: Onali
authors: Elisa
authors: E
authors: Stasi
authors: Roberto
authors: R
authors: Fiori
authors: Simonetta
authors: S
authors: Prencipe
authors: Antonino
authors: A
authors: Bella
authors: Carmelina
authors: C
authors: Petruzziello
authors: Giovanna
authors: G
authors: Condino
authors: Elisabetta
authors: E
authors: Lolli
authors: Giovanni
authors: G
authors: Simonetti
authors: Livia
authors: L
authors: Biancone
authors: Francesco
authors: F
authors: Pallone
mesh_terms: D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult
keywords: CD; CT; Crohn's Disease; Crohn's disease; Cross-Sectional Imaging Technique; Detection; IBD; Inflammatory Bowel Disease; NPV; PEG; PPV; SICUS; US; computed tomography; inflammatory bowel disease; negative predictive value; polyethylene glycol; positive predictive value; small-intestine contrast ultrasonography; ultrasound