Normalization of bowel wall after strictureplasty and miniresection for complicated Crohn's disease

2000 ◽  
Vol 32 ◽  
pp. A34
Author(s):  
G.M. Sampietro ◽  
M. Cristaldi ◽  
G. Maconi ◽  
S. Bollani ◽  
P.G. Danelli ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Wall

MRI of small bowel Crohn’s disease: determining the reproducibility of bowel wall gadolinium enhancement measurements

2009 ◽  
Vol 19 (8) ◽  
pp. 1960-1967 ◽  
Author(s):  
A. Sharman ◽  
I. A. Zealley ◽  
R. Greenhalgh ◽  
P. Bassett ◽  
S. A. Taylor
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Bowel Wall ◽  
Gadolinium Enhancement

scholarly journals P176 Expert consensus on acquisition and reporting of intestinal ultrasonography activity in Crohn’s disease. A prospective inter-rater agreement study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S225-S226
Author(s):  
R T Wilkens ◽  
K Nylund ◽  
F Petersen ◽  
F De Voogd ◽  
C Maaser ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Wall Thickness ◽  
Bowel Wall ◽  
Expert Consensus ◽  
Inflammatory Activity ◽  
Rater Agreement ◽  
Delphi Consensus ◽  
Bowel Wall Thickness ◽  
Independent Expert

Abstract Background Intestinal ultrasonography (IUS) is a promising cross-sectional imaging modality used to assess transmural disease and complications in Crohn’s disease (CD). Although recently positioned as a first-line modality for evaluation as per ECCO guidelines, standard measurements, reproducibility and nomenclature have not yet been clearly established. The aim of this study was to evaluate the inter-rater agreement for parameters identified as important by experts through Delphi consensus. Methods IUS parameters demonstrating inflammatory activity were systematically reviewed in the literature and presented to IUS experts. Individual parameters were selected by a blinded Delphi consensus panel to establish relative contribution to inflammatory activity in CD. Weighted grading of each parameter was further established by expert consensus. Image acquisition for optimal measurement was established by consensus. Two phases for evaluating inter-rater variability were undertaken. Phase 1: blind review by 8 readers of 20 de-identified CD cases. Cases with poor agreement were reviewed to clarify discrepancy and improve agreement. Phase 2: an additional 30 de-identified CD cases blindly were reviewed by 12 independent expert readers. Inter-rater agreement was evaluated for all 4 key parameters. Statistics were performed using Stata 16. Bowel wall thickness (BWT) was assessed using intraclass correlation coefficient (ICC) and the ordinal parameters using weighted Cohens Kappa. Results The Delphi process reduced 12 activity parameters to 4 key contributors including BWT, color Doppler signal (CDI), inflammatory fat and bowel wall echostratification (Figure 1). BWT was regarded as pathologic if the average of 4 measurements were > 3 mm for the small and large bowel, and grades of the additional parameters established (Table 1). Bowel wall thickness was comprised of 2 measurements in cross section and 2 in longitudinal orientation (Figure 2). Interobserver agreement was almost perfect for BWT: ICC=0.91 (95% CI 0.83 to 0.96) p = 0.001, while there was moderate agreement for CDI κ=0.60 (95% CI 0.48–0.72) p = 0.001. Agreement for inflammatory fat detection was also moderate with κ= 0.50 (95% CI 0.33–0.66) p = 0.001, while stratification was fair κ= 0.39 (95% CI 0.26–0.53) p = 0.001. Conclusion This expert consensus-based IUS activity score clearly establishes the reproducibility of this standardised approach to measure inflammatory activity in patients with CD. Using our method, BWT which is known as the most important parameter, is highly reproducible with CDI and inflammatory fat demonstrating moderate reproducibility. This score may provide the foundation for the future incorporation of IUS in research studies and clinical trials.

651 Small Bowel Ultrasound and Computed Tomography Enterography: Characteristics of Bowel Wall and Mesenteric Tissue in the First Diagnosis of Ileal Crohn's Disease

2009 ◽  
Vol 136 (5) ◽  
pp. A-99
Author(s):  
Chiara Trattenero ◽  
Alessandra Losco ◽  
Mirella Fraquelli ◽  
Laura Virginia Forzenigo ◽  
Valentina Sciola ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Bowel Wall ◽  
Computed Tomography Enterography ◽  
Bowel Ultrasound ◽  
First Diagnosis

scholarly journals DOP36 Non-invasive assessment of postoperative disease recurrence in Crohn’s Disease: A multicenter, prospective cohort study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S074-S075
Author(s):  
F Furfaro ◽  
A Zilli ◽  
V Craviotto ◽  
A Aratari ◽  
C Bezzio ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Wall ◽  
Color Doppler ◽  
Disease Recurrence ◽  
Postoperative Recurrence ◽  
Fecal Calprotectin ◽  
Non Invasive ◽  
Endoscopic Recurrence ◽  
Sensitivity Specificity

Abstract Background Prevention of postoperative recurrence is a critical goal in Crohn’s disease (CD) management. Currently, postsurgical CD management and treatment are based on endoscopic monitoring performed within the first year after surgery. However, colonoscopy (CS) is an invasive and expensive procedure, unpleasant to patients. A non-invasive and patient friendly approach is required. Methods Consecutive CD patients who underwent ileo-cecal resection from July 2017 to January 2020 were prospectively enrolled in three Italian Centers and performed CS and bowel ultrasound (US) after six months from the surgery, in a blinded fashion. The patients also underwent complete clinical assessment and blood and stool samples were obtained for C-reactive protein (CRP), and fecal calprotectin (FC) measurements. The disease was considered clinically active if the Harvey–Bradshaw Index (HBI) was higher than 4. Uni- and multivariable analyses were used to assess the correlation between non-invasive parameters, including bowel US findings and FC values and endoscopic recurrence, defined by a Rutgeerts’s score (RS) > 2. Sensitivity, specificity, accuracy, PPV and NPV of bowel US parameters alone and in combination with FC in assessing endoscopic recurrence were calculated. Results Seventy patients were enrolled, 45 patients (64%) had an endoscopic recurrence (RS > 2) at 6 months. Thirteen out of 45 (29%) were symptomatic (HBI > 4). Bowel wall thickness (BWT), bowel wall flow (BWF, presence of vascular signals at color Doppler), the presence of mesenteric hypertrophy, the presence of limph-nodes and FC values significantly correlated with the endoscopic recurrence (p < 0.005). Independent predictors for endoscopic recurrence were BWT (for 1-mm increase: OR 2.63; 95% CI 1.136.12; p= 0.024), presence of lymph-nodes (OR 23.24; 95% CI 1.85291.15; p= 0.014) and FC > 50 µg/g (OR 11.86; 95% CI 2.60–54.09; p= 0.001). Sensitivity, specificity, accuracy, PPV and NPV of bowel US and/or FC are showed in Table 1. Table 1: Diagnostic accuracy of Bowel US and/or FC compared to CS in assessing endoscopic activity (CI 95%): per-patient analysis Conclusion Combined use of bowel US and FC is accurate in assessing endoscopic recurrence at 6 months in CD patients and represent a valid alternative to endoscopic assessment after surgery

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