title: Transcutaneous bowel sonography for inflammatory bowel disease is sensitive and specific when performed in a nonexpert low-volume North American center.
abstract: OBJECTIVE
  Transcutaneous bowel sonography is a nonionizing imaging modality used in inflammatory bowel disease. Although available in Europe, its uptake in North America has been limited. Since the accuracy of bowel sonography is highly operator dependent, low-volume centers in North America may not achieve the same diagnostic accuracy reported in the European literature. Our objective was to determine the diagnostic accuracy of bowel sonography in a nonexpert low-volume center.
  
  
  METHODS
  All cases of bowel sonography at a single tertiary care center during an 18-month period were reviewed. Bowel sonography was compared with reference standards, including small-bowel follow-through, computed tomography, magnetic resonance imaging, colonoscopy, and surgical findings.
  
  
  RESULTS
  A total of 103 cases were included for analysis during the study period. The final diagnoses included Crohn disease (72), ulcerative colitis (8), hemolytic uremic syndrome (1), and normal (22). The sensitivity and specificity of bowel sonography for intestinal wall inflammation were 87.8% and 92.6%, respectively. In the subset of patients who had complications of Crohn disease, the sensitivity and specificity were 50% and 100% for fistulas and 14% and 100% for strictures. One patient had an abscess, which was detected by bowel sonography. Abnormal bowel sonographic findings contributed to the escalation of treatment in 55% of cases.
  
  
  CONCLUSIONS
  Bowel sonography for inflammatory bowel disease can be performed in low-volume centers and provides diagnostic accuracy for luminal disease comparable with published data, although it is less sensitive for complications of Crohn disease.
authors.affiliation: Department of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada.
authors.forename: Michael Sai Lai
authors.initials: MS
authors.lastname: Sey
authors.forename: Jamie
authors.initials: J
authors.lastname: Gregor
authors.forename: Nilesh
authors.initials: N
authors.lastname: Chande
authors.forename: Terry
authors.initials: T
authors.lastname: Ponich
authors.forename: Mousumi
authors.initials: M
authors.lastname: Bhaduri
authors.forename: Andrea
authors.initials: A
authors.lastname: Lum
authors.forename: Witek
authors.initials: W
authors.lastname: Zaleski
authors.forename: Brian
authors.initials: B
authors.lastname: Yan
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D015212:Inflammatory Bowel Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D007422:Intestines / Q000000981:diagnostic imaging*; D008297:Male; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D011361:Professional Competence / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000706:statistics & numerical data*
keywords: bowel sonography; inflammatory bowel disease; sensitivity; specificity