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Pediatric Small Bowel Crohn Disease: Correlation of US and MR Enterography
Jonathan R Dillman1, Ethan A Smith, Ramon J Sanchez
1From the Section of Pediatric Radiology, Department of Radiology (J.R.D., E.A.S., R.J.S., M.A.D., P.J.S.), and Division of Pediatric Gastroenterology, Department of Pediatrics and Communicable Diseases (V.D.M.), C.S. Mott Children's Hospital, University of Michigan Health System, 1540 E Hospital Dr, Ann Arbor, MI 48109; and Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (K.D.).
Insights
Ultrasonography (US) is an effective, low-cost imaging tool for pediatric small bowel Crohn disease. This well-tolerated method offers advantages over other imaging techniques for diagnosis and follow-up.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Inflammatory Bowel Disease
Background:
- Small bowel Crohn disease (CD) is increasingly diagnosed in children.
- Current diagnostic methods include history, physical exam, lab tests, endoscopy, and imaging.
- Imaging is crucial for diagnosis and monitoring pediatric CD.
Purpose of the Study:
- To evaluate ultrasonography (US) as an imaging modality for pediatric small bowel Crohn disease.
- To compare the advantages of US with computed tomographic (CT) enterography and magnetic resonance (MR) enterography.
Main Methods:
- Review of ultrasonography (US) applications in pediatric small bowel Crohn disease.
- Comparison of US characteristics with CT enterography and MR enterography.
Main Results:
- Ultrasonography is an underutilized, well-tolerated imaging technique for pediatric CD.
- US offers advantages: low cost, no contrast material, high spatial resolution, faster examination, no radiation, and no sedation.
- US accurately visualizes small bowel and mesenteric changes in pediatric CD patients.
- US findings correlate highly with MR imaging findings.
Conclusions:
- Ultrasonography is a valuable, advantageous imaging tool for screening and follow-up of pediatric small bowel Crohn disease.
- US presents a compelling alternative to CT and MR enterography in this population.
Abstract:
Small bowel Crohn disease is commonly diagnosed during the pediatric period, and recent investigations show that its incidence is increasing in this age group. Diagnosis and follow-up of this condition are commonly based on a combination of patient history and physical examination, disease activity surveys, laboratory assessment, and endoscopy with biopsy, but imaging also plays a central role. Ultrasonography (US) is an underutilized well-tolerated imaging modality for screening and follow-up of small bowel Crohn disease in children and adolescents. US has numerous advantages over computed tomographic (CT) enterography and magnetic resonance (MR) enterography, including low cost and no required use of oral or intravenous contrast material. US also has the potential to provide images with higher spatial resolution than those obtained at CT enterography and MR enterography, allows faster examination than does MR enterography, does not involve ionizing radiation, and does not require sedation or general anesthesia. US accurately depicts small bowel and mesenteric changes related to pediatric Crohn disease, and US findings show a high correlation with MR imaging findings in this patient population.
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