Impact of intestinal ultrasound with a portable system in the management of Crohn's disease
Impact of intestinal ultrasound with a portable system in the management of Crohn's disease
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Tarih
2021-01-01
Yazarlar
Gonen, Can
Surmelioglu, Ali
Kochan, Koray
Ozer, Serhat
Aslan, Ekrem
Tilki, Metin
Süreli Yayın başlığı
Süreli Yayın ISSN
Cilt Başlığı
Yayınevi
OXFORD UNIV PRESS
Dergi Adı
GASTROENTEROLOGY REPORT
Özet
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 clinical-management decisions. With further supporting data, this practice would possibly become a requirement for CD management.
Açıklama
Anahtar kelimeler
Crohn's disease, inflammatory bowel diseases, point-of-care, portable, ultrasound, monitoring