title: Usefulness of abdominal ultrasonography in the analysis of endoscopic activity in patients with Crohn's disease: changes following treatment with immunomodulators and/or anti-TNF antibodies.
abstract: OBJECTIVE
  The objective of this study was to analyze the accuracy of abdominal ultrasonography (AUS) in the assessment of mucosal healing in patients with Crohn's disease (CD) receiving immunomodulators and/or biological treatment, with ileocolonoscopy as the reference standard.
  
  
  METHODS
  Thirty patients were included in a prospective longitudinal study. All patients underwent ileocolonoscopy and AUS before and after a minimum of one year of treatment. The Crohn's Disease Endoscopic Inflammatory Index of Severity (CDEIS) was used for endoscopic assessment whereas AUS was analyzed by means of bowel wall thickness, color Doppler grade and percentage of increase of parietal enhancement after contrast injection.
  
  
  RESULTS
  In the segmental analysis, endoscopic healing was found in 71.2% of the segments and AUS findings were normalized in 62.8%, with a significant correlation between the two techniques (κ=0.76, p<0.001). In the overall assessment performed after treatment, 18 (60%) patients exhibited endoscopic remission (CDEIS <6 points); of these patients, 15 (83.3%) had normalized sonographic findings, with a good correlation between endoscopic remission and sonographic normalization (κ=0.73, p<0.001). Of the three variables assessed by AUS, parietal thickness was the best variable to predict mucosal healing in both analyses, segmental and global.
  
  
  CONCLUSIONS
  Abdominal ultrasonography is a useful and reliable technique for the assessment of the endoscopic response to treatment with immunomodulators and/or biological drugs in Crohn's disease. AUS is a highly accurate technique for evaluating the healing of the intestinal mucosa.
authors.affiliation: Servicios de Medicina Digestiva y Radiodiagnóstico, Hospital Universitario Dr. Peset. Valencia, Universidad de Valencia, Spain. Electronic address: nadiapa88@hotmail.com.
authors.forename: Nadia
authors.initials: N
authors.lastname: Moreno
authors.affiliation: Servicios de Medicina Digestiva y Radiodiagnóstico, Hospital Universitario Dr. Peset. Valencia, Universidad de Valencia, Spain. Electronic address: ripolles_tom@gva.es.
authors.forename: Tomás
authors.initials: T
authors.lastname: Ripollés
authors.affiliation: Servicios de Medicina Digestiva y Radiodiagnóstico, Hospital Universitario Dr. Peset. Valencia, Universidad de Valencia, Spain. Electronic address: paredes_jos@gva.es.
authors.forename: José María
authors.initials: JM
authors.lastname: Paredes
authors.affiliation: Servicios de Medicina Digestiva y Radiodiagnóstico, Hospital Universitario Dr. Peset. Valencia, Universidad de Valencia, Spain. Electronic address: ortiz_inmpol@gva.es.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Ortiz
authors.affiliation: Servicios de Medicina Digestiva y Radiodiagnóstico, Hospital Universitario Dr. Peset. Valencia, Universidad de Valencia, Spain. Electronic address: chusjmartinez@gmail.com.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Martínez
authors.affiliation: Servicios de Medicina Digestiva y Radiodiagnóstico, Hospital Universitario Dr. Peset. Valencia, Universidad de Valencia, Spain. Electronic address: lopez_antser@gva.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: López
authors.affiliation: Servicios de Medicina Digestiva y Radiodiagnóstico, Hospital Universitario Dr. Peset. Valencia, Universidad de Valencia, Spain. Electronic address: frudelgado@gmail.com.
authors.forename: Fructuoso
authors.initials: F
authors.lastname: Delgado
authors.affiliation: Servicios de Medicina Digestiva y Radiodiagnóstico, Hospital Universitario Dr. Peset. Valencia, Universidad de Valencia, Spain. Electronic address: moreno_edu@gva.es.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Moreno-Osset
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D055815:Young Adult
chemical_list: D000276:Adjuvants, Immunologic; D007155:Immunologic Factors; D014409:Tumor Necrosis Factor-alpha
keywords: Abdominal ultrasound; Crohn's disease; Mucosal healing