Intestinal ultrasound effectively measures bowel wall thickness, endoscopic disease
Click Here to Manage Email Alerts
A point-of-care intestinal ultrasound effectively assessed endoscopic disease severity through bowel wall thickness, according to a poster presentation.
“...[T]his study demonstrates that in patients suspected to have inflammatory bowel disease, intestinal ultrasound (IUS) cannot only change the pretest probability of disease activity before a colonoscopy, but bowel wall thickness (BWT) can help predict the severity of disease activity,” Mallory Chavannes, MD, MHSc, assistant professor of Pediatrics at the Children's Hospital Los Angeles Division of Gastroenterology, Hepatology, & Nutrition, told Healio Gastroenterology. “Using that information, we can better triage patients who may need early evaluations and start therapy in a timely fashion.”
Chavannes and colleagues enrolled 30 patients with newly diagnosed IBD (40% female; median age 15 years) who presented to the IBD outpatient clinic or were hospitalized in the researchers’ pediatric center between August 2020 and September 2021. Of the 30 patients, 56.7% had Crohn’s disease and 30% had ulcerative colitis.
According to the poster, researchers measured BWT across different bowel segments (terminal ileum, ascending, transverse, descending, sigmoid colon and rectum) and recorded measures twice in both longitudinal and axial view. The researchers considered an average segmental BWT of 3 mm as inflamed.
Gastroenterologists who performed IUS were blinded to previous ileocolonoscopic results to assess the effectiveness of IUS on measuring BWT.
Of the 23 patients who completed both an IUS and a colonoscopy, 13 received a diagnosis of CD, seven received a diagnosis of UC and three had a normal colonoscopy.
According to the poster, IUS detection of disease activity as compared with colonoscopy provided a sensitivity of 87% (95% CI, 72-96), a specificity of 60% (95% CI, 51-69), a positive pressure ventilation of 41% (95% CI, 30-52), a negative predictive value of 94% (95% CI, 85-98) and an accuracy of 69% (95% CI, 60-76).
“Similar findings have been demonstrated in adult populations from European groups and the radiology literature,” Chavannes said. “However, these findings are new in children and performed as point-of-care.”
According to the poster, although current methods to visually assess disease activity in North American pediatric practice are limited to ileocolonoscopies and MR-enterography, the results supported the use of point-of-care IUS as an effective tool in evaluating disease severity that correlated with BWT in pediatric patients with IBD.
“Previous and ongoing studies have shown changes and improvement in bowel wall thickness on IUS after treatment initiation,” Chavannes concluded. “Importantly, this research opens the door to further controlled trials to demonstrate the impact of IUS in daily practice and its potential to provide an accessible biomarker of disease activity.”
Collapse
Chavannes M, et al. Poster 182. Presented at: North American Society for Pediatric Gastroenterology, Hepatology & Nutrition Annual Meeting; Dec. 12-18, 2021 (virtual meeting).
Click Here to Manage Email Alerts