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Ultrasonographic Findings Correspond to Clinical, Endoscopic, and Histologic Findings in Inflammatory Bowel Disease and Other Enterocolitides

Departments of Pediatrics (H.P.H., A.B., R.Z., M.S.), Internal Medicine (S.D.), and Pathology (P.R.), University of Tübingen, Tübingen, Germany.

Address correspondence and reprint requests to Hans P. Haber, MD, Universitäts-Kinderklinik, Hoppe-Seyler-Strasse 1, D-72076 Tübingen, Germany.

Objective. To compare results obtained by abdominal ultrasonography with clinical findings, including endoscopic and histologic findings, to evaluate the location and activity of inflammatory bowel disease, including disease controls in children. Methods. Ninety-two ultrasonographic scans and 41 colonoscopic examinations with biopsies were performed in 78 patients (1 month to 17.8 years of age) with Crohn's disease (n = 26), ulcerative colitis (n = 21), inflammatory bowel disease of indeterminate type (n = 2), and disease controls (other intestinal disorders, including infectious and ischemic lesions; n = 29). Laboratory parameters for inflammatory bowel disease were determined, and disease activity was assessed by a combination of clinical and laboratory data. Bowel wall thickness and echo texture were recorded in a standardized way by ultrasonography and compared with endoscopic and histologic findings in a segment-by-segment comparison. Results. Sensitivity and specificity of ultrasonography in detecting patients with severe macroscopic lesions depicted on endoscopy were 77% and 83%, respectively. Sensitivity and specificity of ultrasonography in detecting patients with severe histologic inflammation were 75% and 82%. There was a statistically significant correlation between maximal bowel wall thickness and disease activity score (P < .01). Conclusions. Abdominal ultrasonography may be helpful in evaluating the location, severity, and inflammatory activity of inflammatory bowel disease in children and young adults.

Abbreviations: CD, Crohn's disease • DC, disease control • IBD, inflammatory bowel disease • PCDAI, Pediatric Crohn's Disease Activity Index • UC, ulcerative colitis • ALT, alanine aminotransferase • AST, aspartate amino-transferase • BSO, bilateral salpingo-oophorectomy • DDUS, duplex Doppler ultrasonography • HDL, high-den-sity lipoprotein • HRT, hormone replacement therapy • LDL, low-density lipoprotein • PI, pulsatility index • TAH, total abdominal hysterectomy

Key Words: Crohn's disease • ulcerative colitis • disease activity • ileum and colon wall thickness • bowel wall ultrasonographic echo texture

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