title: Bowel elastography - a pilot study for developing an elastographic scoring system to evaluate disease activity in pediatric Crohn's disease.
abstract: The diagnosis and monitoring of Crohn's disease (CD) represents a diagnosis challenge in which imaging plays an important role.
  
  
  OBJECTIVE
  In the present paper we aim to demonstrate the role of sonoelastography (SE), performed in addition to hydrosonography (HS), in the evaluation of CD in children and to propose a scoring system for the appreciation of disease activity.
  
  
  METHODS
  All the patients included into the study were diagnosed with CD and had underwent HS and SE as part of the imaging evaluation. In selected cases magnetic resonance enterography (MRE) was also performed. SE aspects were classified into three types, each corresponding to a specific bowel wall pattern: normal or remission (type A), inflammation (type B) and fibrosis (type C); this classification represents the basis of the scoring system. For the purpose of statistical analysis each evaluated bowel segment became an individual case.
  
  
  RESULTS
  Forty eight bowel segments were evaluated by SE: 21 type A, 20 type B and 7 type C. Statistically significant correlations were found between the intestinal wall HS changes, presence of complications, activity markers and the SE score. The HS assessment of the periintestinal area correlated only partially with SE score, while certain SE scores also proved to be predictors for the presence of complications or for increased values of the disease activity markers.
  
  
  CONCLUSIONS
  SE, along with HS, represents a reliable investigation in the correct diagnosis and monitoring of pediatric patients with CD and the SE scoring system may be introduced as a method for the assessment of disease activity.
authors.affiliation: Department of Radiology, Children Emergency Hospital, Cluj-Napoca, Romania. otilia.fufezan@gmail.com.
authors.forename: Otilia
authors.initials: O
authors.lastname: Fufezan
authors.affiliation: Department of Radiology, Children Emergency Hospital, Cluj-Napoca, Romania.
authors.forename: Carmen
authors.initials: C
authors.lastname: Asavoaie
authors.affiliation: Department of Radiology, Children Emergency Hospital, Cluj-Napoca, Romania.
authors.forename: Attila
authors.initials: A
authors.lastname: Tamas
authors.affiliation: Department of Gastroenterology, Children Emergency Hospital, Cluj-Napoca, Romania.
authors.forename: Dorin
authors.initials: D
authors.lastname: Farcau
authors.affiliation: Department of Gastroenterology, Children Emergency Hospital, Cluj-Napoca, Romania.
authors.forename: Daniela
authors.initials: D
authors.lastname: Serban
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D003106:Colon / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index