title: Impact of Intestinal Ultrasound on Classification and Management of Crohn's Disease Patients with Inconclusive Colonoscopy.
abstract: Background and Aims. We aim to evaluate the benefit of ultrasound in the assessment of Crohn's disease and to demonstrate its potential contribution to disease management. Methods. We conduct a retrospective review of adult patients with Crohn's disease examined with sonography and colonoscopy within 30 days. Study patients were identified in whom colonoscopy did not access a pathological segment, detected and evaluated by ultrasonography. Changes in management were predominantly attributed to ultrasound in those cases where the diseased segment was not assessed on endoscopy. Results. From 115 patients with temporally related ileocolonoscopy and ultrasound, 41 had disease fully assessed on ultrasound only, with complications in 26/41. Twenty-nine of 41 had mild or no endoscopic inflammation with moderate or severe disease on ultrasound at the same segment or at a segment proximal to the reach of the endoscope. Changes in management were significantly attributed to ultrasound in 22 of these 29 patients. Conclusion. The benefit of cross-sectional imaging is invaluable for the comprehensive assessment of bowel not shown on ileocolonoscopy. Ultrasound may make a significant contribution to correct classification of disease extent and severity of Crohn's disease. Prospective studies are needed to further understand the contribution of US in patient management.
authors.affiliation: Department of Radiology, University of Calgary, Calgary, AB, Canada T2N 2T9; Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, AB, Canada T2N 2T9; Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, 8600 Silkeborg, Denmark; Department of Hepatology and Gastroenterology, Aarhus University Hospital, 8000 Aarhus C, Denmark.
authors.forename: Rune
authors.identifier: 0000-0002-4928-4708
authors.initials: R
authors.lastname: Wilkens
authors.affiliation: Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, AB, Canada T2N 2T9.
authors.forename: Kerri L
authors.initials: KL
authors.lastname: Novak
authors.affiliation: Department of Radiology, University of Calgary, Calgary, AB, Canada T2N 2T9.
authors.forename: Eleonore
authors.initials: E
authors.lastname: Lebeuf-Taylor
authors.affiliation: Department of Radiology, University of Calgary, Calgary, AB, Canada T2N 2T9; Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, AB, Canada T2N 2T9.
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Wilson
mesh_terms: D000328:Adult; D003113:Colonoscopy / Q000706:statistics & numerical data; D003424:Crohn Disease / Q000145:classification* / Q000000981:diagnostic imaging* / Q000473:pathology; D019468:Disease Management; D019160:Endosonography / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index