Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke · 2010
[Transabdominal ultrasonography inflammatory intestinal syndrome].
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Naevdal Erlend Fjell, Nylund Kim, Gilja Odd Helge
Аннотация
BACKGROUND: During the last 15 years transabdominal ultrasonography has been used increasingly for assessment of patients with inflammatory bowel disease. Approximately 300 such examinations are performed annually in the medical department at Haukeland University Hospital. This article reviews the use of ultrasonography in ulcerative colitis and Crohn's disease.
MATERIAL AND METHODS: The articles referred to were found in our own literature archive or in PubMed (a non-systematic search was performed).
RESULTS: Patients with Crohn's disease often have thickened bowel wall and altered wall structure (as shown by transabdominal ultrasonography). In ulcerative colitis the wall structure is often preserved, the disease limited to the colon and the wall only slightly to moderately thickened. The sensitivity for diagnosing inflammatory bowel disease is around 85 % and the specificity 95 % and that for Crohn's disease is 88 % and 93 %. In patients with complicated Crohn's disease transabdominal ultrasonography is best for detecting stenoses (sensitivity 74-100 %, specificity 91-100 %), but less effective for fistulas (sensitivity 71 %, specificity 96 %) and abscesses (sensitivity 81 %, specificity 93 %). Local hyperaemia in the bowel wall suggests inflammation and can be detected with colour Doppler.
INTERPRETATION: Transabdominal ultrasonography is useful for primary diagnostics and in follow-up of patients with inflammatory bowel disease. The examinations are most successful when performed by a clinician who knows the patient and is familiar with bowel ultrasonography.
MATERIAL AND METHODS: The articles referred to were found in our own literature archive or in PubMed (a non-systematic search was performed).
RESULTS: Patients with Crohn's disease often have thickened bowel wall and altered wall structure (as shown by transabdominal ultrasonography). In ulcerative colitis the wall structure is often preserved, the disease limited to the colon and the wall only slightly to moderately thickened. The sensitivity for diagnosing inflammatory bowel disease is around 85 % and the specificity 95 % and that for Crohn's disease is 88 % and 93 %. In patients with complicated Crohn's disease transabdominal ultrasonography is best for detecting stenoses (sensitivity 74-100 %, specificity 91-100 %), but less effective for fistulas (sensitivity 71 %, specificity 96 %) and abscesses (sensitivity 81 %, specificity 93 %). Local hyperaemia in the bowel wall suggests inflammation and can be detected with colour Doppler.
INTERPRETATION: Transabdominal ultrasonography is useful for primary diagnostics and in follow-up of patients with inflammatory bowel disease. The examinations are most successful when performed by a clinician who knows the patient and is familiar with bowel ultrasonography.