Clinical Feature and Bowel Ultrasound in Crohn’s Disease – Does Additional Information from Magnetic Resonance Imaging Affect Therapeutic Approach and When Does Extended Diagnostic Investigation Make Sense?

URN to cite this document:

urn:nbn:de:bvb:355-epub-409049 Copy

DOI to cite this document:

10.5283/epub.40904 Copy

Ott, Claudia ; Girlich, Christiane ; Strauch, Ulrike ; Schacherer, Doris ; Obermeier, Florian ; Jung, Ernst Michael ; Schölmerich, Jürgen ; Schreyer, Andreas Georg ; Klebl, Frank

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Date of publication of this fulltext: 24 Oct 2019 12:09

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Details

Item type:	Article
Open Access Type:	Alliance-/National licence
Journal or Publication Title:	Digestion
Publisher:	Karger
Volume:	83
Page Range:	pp. 18-23
Date:	2011
Additional Information (public):	OA-Komponente aus Allianzlizenz
Institutions:	Medicine > Lehrstuhl für Innere Medizin I Medicine > Lehrstuhl für Röntgendiagnostik
Identification Number:	Value Type 10.1159/000314590 DOI
Keywords:	Crohn’s disease, MR enterography, Ultrasound, Therapeutic approach
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Yes
Item ID:	40904

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Abstract

Background/Aims: Some suggest MRI to be superior to ultrasound in Crohn’s disease. We analyzed how often MR enterography (MRE) following a routine ultrasound leads to a change in therapeutic decision. Material and Methods: We retrospectively evaluated 47 patients with Crohn’s disease undergoing routine ultrasound examination. Actual medical history, complete blood count, C-reactive protein (CRP), ...

Abstract

Background/Aims: Some suggest MRI to be superior to ultrasound in Crohn’s disease. We analyzed how often MR enterography (MRE) following a routine ultrasound leads to a change in therapeutic decision. Material and Methods: We retrospectively evaluated 47 patients with Crohn’s disease undergoing routine ultrasound examination. Actual medical history, complete blood count, C-reactive protein (CRP), and sonographic findings were assessed independently by two specialists who retrospectively provided a therapeutic proposal. Additionally, all patients received MRE. Thereafter, the specialists had to provide a new therapeutic concept regarding all the available information. Results: Evaluation of the rectum was not successful by ultrasound, but MRE gave good results. Only 1 of 7 abscesses was identified sonographically. Three of the abscesses missed at sonography were localized in the perirectal/perianal region. MRE detected more inflamed bowel segments, but ultrasound assessment of anatomically fixed bowel parts showed good recognition by MRE. With increasing CRP values, we found more positive results of ultrasound and MRE. Therapeutic change was suggested in only 18 patients. Conclusions: Ultrasound should be performed by an experienced examiner, and a proctological examination should be added. MRE is justified in cases of discrepancy between clinical findings and the results of diagnostic ultrasound and, moreover, if Crohn’s lesions are suspected at sites proximal to the terminal or neoterminal ileum.

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