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Color-coded duplex sonography compared to multidetector computed tomography for the diagnosis of crohn disease
Diana Gaitini1, Adam J Kreitenberg, Doron Fischer
1Department of Medical Imaging, Rambam Health Care Campus and Faculty of Medicine, Technion, Israel Institute of Technology, Ha'alya Ha'shnia 8, PO Box 9602, 31096 Haifa, Israel. d_gaitini@rambam.health.gov.il
Objectives:
The purpose of this study was to evaluate the accuracy of color-coded duplex sonography for the diagnosis of Crohn disease relapse and complications compared to multidetector computed tomography (CT).
Methods:
The Institutional Ethics Committee approved the protocol research, and written consent forms were obtained. Patients with a diagnosis of Crohn disease presenting with symptoms of relapse or complications (54 patients; 27 female; ages 9-80 years; mean, 34.6 years) were enrolled. Patients underwent color-coded duplex sonography and multidetector CT examinations within 2 weeks of each other. Multidetector CT was the reference standard. The location and extent of diseased bowel, wall thickness, stenosis, hyperemia, mesenteric fat thickening, lymphadenopathy, abscesses, fistulas, peritoneal fluid, and signs of hepatobiliary disease were searched for.
Results:
About of 80% of the patients had terminal ileal involvement, and 55% had disease confined to the ileum. A significant correlation between the two modalities was found regarding wall thickness, abscesses, and fistulas (P < .05). Color-coded duplex sonography had sensitivity and specificity of 88% and 53%, respectively, for diagnosis of luminal stenosis. Hyperemia was more commonly diagnosed on color-coded duplex sonography. Color-coded duplex sonography had sensitivity and specificity of 84% and 83% for diagnosis of mesenteric fat thickening and lymphadenopathy and 66% and 86% for peritoneal fluid. Fatty liver was found in 18% and gallstone disease in 6%.
Conclusions:
Color-coded duplex sonography was accurate in diagnosing the disease location, wall thickness, and extraintestinal inflammatory findings associated with Crohn disease, potentially placing it as the first-line imaging modality for the diagnosis of Crohn disease relapse and complications.
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