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Bowel elastography - a pilot study for developing an elastographic scoring system to evaluate disease activity in
Otilia Fufezan1, Carmen Asavoaie2, Attila Tamas2
1Department of Radiology, Children Emergency Hospital, Cluj-Napoca, Romania. otilia.fufezan@gmail.com.
Insights
Sonoelastography (SE) combined with hydrosonography (HS) aids in diagnosing and monitoring pediatric Crohn
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Gastrointestinal Diseases
Background:
- Crohn's disease (CD) diagnosis and monitoring present challenges.
- Imaging modalities are crucial for evaluating CD.
- Sonoelastography (SE) offers potential for enhanced assessment.
Purpose of the Study:
- To demonstrate the role of SE, alongside hydrosonography (HS), in evaluating pediatric CD.
- To propose a scoring system using SE for assessing disease activity.
Main Methods:
- Patients with CD underwent HS and SE.
- SE classified bowel wall patterns into normal/remission (Type A), inflammation (Type B), and fibrosis (Type C).
- A scoring system was developed based on SE classification.
Main Results:
- Significant correlations were found between SE scores and HS findings, complications, and disease activity markers.
- SE scores predicted complications and elevated activity markers.
- SE demonstrated reliability in assessing bowel wall characteristics.
Conclusions:
- SE, in conjunction with HS, is a reliable tool for diagnosing and monitoring pediatric CD.
- The developed SE scoring system can effectively assess disease activity.
Unlabelled:
The diagnosis and monitoring of Crohn's disease (CD) represents a diagnosis challenge in which imaging plays an important role.
Aim:
In the present paper we aim to demonstrate the role of sonoelastography (SE), performed in addition to hydrosonography (HS), in the evaluation of CD in children and to propose a scoring system for the appreciation of disease activity.
Material And Method:
All the patients included into the study were diagnosed with CD and had underwent HS and SE as part of the imaging evaluation. In selected cases magnetic resonance enterography (MRE) was also performed. SE aspects were classified into three types, each corresponding to a specific bowel wall pattern: normal or remission (type A), inflammation (type B) and fibrosis (type C); this classification represents the basis of the scoring system. For the purpose of statistical analysis each evaluated bowel segment became an individual case.
Results:
Forty eight bowel segments were evaluated by SE: 21 type A, 20 type B and 7 type C. Statistically significant correlations were found between the intestinal wall HS changes, presence of complications, activity markers and the SE score. The HS assessment of the periintestinal area correlated only partially with SE score, while certain SE scores also proved to be predictors for the presence of complications or for increased values of the disease activity markers.
Conclusions:
SE, along with HS, represents a reliable investigation in the correct diagnosis and monitoring of pediatric patients with CD and the SE scoring system may be introduced as a method for the assessment of disease activity.
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