title: Transperineal ultrasonography: First level exam in IBD patients with perianal disease.
abstract: BACKGROUND
  A pelvic magnetic resonance imaging (MRI) represents the front-line method for evaluating perianal disease in patients with inflammatory bowel disease (IBD). Recently, transperineal ultrasonography (TPUS) has been proposed as a simple, safe, time-sparing and useful diagnostic technique to assess different pathological conditions of the pelvic floor.
  
  
  OBJECTIVE
  The aim of this prospective single centre study was to evaluate the accuracy of TPUS versus MRI for the detection and classification of perineal disease in IBD patients.
  
  
  METHODS
  From November 2013 to November 2014, 28 IBD patients underwent either TPUS or MRI. Fistulae and abscesses were classified according to Parks' and AGA's classification methods. A concordance was assessed by k statistics.
  
  
  RESULTS
  Overall, 33 fistulae and 8 abscesses were recognized by TPUS (30 and 7 by MRI, respectively). The agreement between TPUS and MRI was 75% according to Parks' classification (k=0.67) and 86% according to AGA classification (k=0.83), while it was 36% (k=0.34) for classifying abscesses.
  
  
  CONCLUSIONS
  TPUS proved to be as accurate as MRI for detecting superficial and small abscesses and for classifying perianal disease. Both examinations may be performed at the initial presentation of the patient, but TPUS is a cheaper, time-sparing procedure. The optimal use of TPUS might be in follow-up patients.
authors.affiliation: Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: terracciano74@hotmail.it.
authors.forename: Fulvia
authors.initials: F
authors.lastname: Terracciano
authors.affiliation: Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: scalisi.giuseppe@alice.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Scalisi
authors.affiliation: Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: f.bossa@operapadrepio.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bossa
authors.affiliation: Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: danisci@hotmail.com.
authors.forename: Daniela
authors.initials: D
authors.lastname: Scimeca
authors.affiliation: Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: giuseppe.biscaglia@gmail.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biscaglia
authors.affiliation: Radiology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: mimangia2@gmail.com.
authors.forename: Michele
authors.initials: M
authors.lastname: Mangiacotti
authors.affiliation: Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: mr.valvano@operapadrepio.it.
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Valvano
authors.affiliation: Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: f.perri@operapadrepio.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Perri
authors.affiliation: Radiology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: a.simeone@operapadrepio.it.
authors.forename: Anna
authors.initials: A
authors.lastname: Simeone
authors.affiliation: Gastroenterology Unit, I.R.C.C.S. "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy. Electronic address: a.andriulli@operapadrepio.it.
authors.forename: Angelo
authors.initials: A
authors.lastname: Andriulli
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging*; D000328:Adult; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D007558:Italy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000000981:diagnostic imaging* / Q000473:pathology; D011446:Prospective Studies; D012003:Rectal Fistula / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult
keywords: Inflammatory bowel disease; Perineal disease; Transperineal ultrasound