Background:Intestinal ultrasound(IUS)is a valid cross-sectional imaging technique for the evaluation of Crohn’s disease(CD).With advancements in technology,portable ultrasound systems are becoming widely available,an...Background:Intestinal ultrasound(IUS)is a valid cross-sectional imaging technique for the evaluation of Crohn’s disease(CD).With advancements in technology,portable ultrasound systems are becoming widely available,and the inevitable change to their use by non-radiologist clinicians would be a valuable contribution to improving patient care.This study aimed to investigate the diagnostic yield of IUS examination performed by a gastroenterologist with a portable system as an adjunct imaging modality in the routine care of CD patients.Methods:A total of 117 CD patients were assessed by IUS imaging.Pre-and post-IUS clinical-management decisions were recorded.The primary outcome was to evaluate the change in the patients’clinical-management decision following the IUS examination.The diagnostic accuracy was compared against the reference decision reached via a multidisiplinary meeting after the evaluation of all patient-related data.The endoscopic disease activity was determined using the simple endoscopic score for Crohn’s disease(SES-CD).Results:The initial clinical-management decision was changed in 47 patients(40.2%)after the IUS examination(P=0.001).The accuracy of patient-management decisions improved from 63.2%to 90.6%in comparison to reference decisions(P<0.001).After IUS examination,a further 13 cases(11.1%)were identified for urgent surgical/interventional procedures.The accuracy of colonoscopic(SES-CD≥3)assessment was shown to be comparable to that of IUS(94%vs 91%).The sensitivity for disease presence was 95%with colonoscopy and 94%with the IUS assessment.Conclusion:IUS examination with the use of a portable ultrasonography system significantly improves clinicalmanagement decisions.With further supporting data,this practice would possibly become a requirement for CD management.展开更多
文摘Background:Intestinal ultrasound(IUS)is a valid cross-sectional imaging technique for the evaluation of Crohn’s disease(CD).With advancements in technology,portable ultrasound systems are becoming widely available,and the inevitable change to their use by non-radiologist clinicians would be a valuable contribution to improving patient care.This study aimed to investigate the diagnostic yield of IUS examination performed by a gastroenterologist with a portable system as an adjunct imaging modality in the routine care of CD patients.Methods:A total of 117 CD patients were assessed by IUS imaging.Pre-and post-IUS clinical-management decisions were recorded.The primary outcome was to evaluate the change in the patients’clinical-management decision following the IUS examination.The diagnostic accuracy was compared against the reference decision reached via a multidisiplinary meeting after the evaluation of all patient-related data.The endoscopic disease activity was determined using the simple endoscopic score for Crohn’s disease(SES-CD).Results:The initial clinical-management decision was changed in 47 patients(40.2%)after the IUS examination(P=0.001).The accuracy of patient-management decisions improved from 63.2%to 90.6%in comparison to reference decisions(P<0.001).After IUS examination,a further 13 cases(11.1%)were identified for urgent surgical/interventional procedures.The accuracy of colonoscopic(SES-CD≥3)assessment was shown to be comparable to that of IUS(94%vs 91%).The sensitivity for disease presence was 95%with colonoscopy and 94%with the IUS assessment.Conclusion:IUS examination with the use of a portable ultrasonography system significantly improves clinicalmanagement decisions.With further supporting data,this practice would possibly become a requirement for CD management.
