A Simple Ultrasound Score for the Accurate Detection of Inflammatory Activity in Crohn's Disease.
Inflamm Bowel Dis
; 23(11): 2001-2010, 2017 11.
Article
em En
| MEDLINE
| ID: mdl-28644185
ABSTRACT
BACKGROUND:
Ultrasound is accurate in the detection of Crohn's disease. Our aim was to identify ultrasound parameters contributing to inflammatory disease activity, develop a simple score, and validate this score prospectively.METHODS:
This study comprised 2 single-center investigations. The first was a retrospective study on a population that had received colonoscopies (as a gold-standard diagnostic) within 60 days of ultrasound. The second was a prospective study on 2 populations patients requiring induction with adalimumab and patients on adalimumab maintenance therapy. Ultrasound and endoscopy were preformed within 14 days in both prospective groups. The endoscopy results were graded with the Simple Endoscopic Score and the Rutgeerts score and compared with 5 ultrasound parameters. We used a proportional odds model to determine which ultrasound parameters correlated significantly with the endoscopy results. We then developed a predictive ultrasound score for disease activity, plotted the receiver operating characteristic curves, and undertook prospective validation of the score.RESULTS:
We evaluated 160 patients retrospectively to compare ultrasound and colonoscopy. Two of 5 parameters were found to correlate significantly with disease activity bowel wall thickness (P = <0.0001) and color Doppler signal (P = 0.0292). We developed a score that uses weighted variables. The area under the corresponding receiver operating characteristic curve was 0.8658.CONCLUSIONS:
A simple ultrasonographic score that accurately identifies Crohn's disease activity has been developed and validated. Ultrasound may be a surrogate for endoscopy to guide disease management, but future studies should be conducted to establish interrater variability.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença de Crohn
/
Ultrassonografia
/
Colonoscopia
/
Adalimumab
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Inflamm Bowel Dis
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Canadá