Small intestine contrast ultrasonography (SICUS) for the detection of small bowel complications in crohn's disease: A prospective comparative study versus intraoperative findings
Article first published online: 21 MAR 2011
Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 18, Issue 1, pages 74–84, January 2012
How to Cite
Pallotta, N., Vincoli, G., Montesani, C., Chirletti, P., Pronio, A., Caronna, R., Ciccantelli, B., Romeo, E., Marcheggiano, A. and Corazziari, E. (2012), Small intestine contrast ultrasonography (SICUS) for the detection of small bowel complications in crohn's disease: A prospective comparative study versus intraoperative findings. Inflamm Bowel Dis, 18: 74–84. doi: 10.1002/ibd.21678
- Issue published online: 11 DEC 2011
- Article first published online: 21 MAR 2011
- Manuscript Accepted: 17 JAN 2011
- Manuscript Received: 28 DEC 2010
- Crohn's disease;
- small intestine, morphology, pathology;
- ultrasonography, SICUS
In Crohn's disease (CD) patients, small intestine contrast ultrasonography (SICUS) accurately assesses small bowel lesions. Its diagnostic role is not known in the assessment of intraabdominal CD complications. The aim was to assess the value of SICUS to detect intestinal complications in patients with CD.
Forty-nine CD patients (21 female, mean age 37.7 years; range 12–78 years) underwent resective bowel surgery and were included in this study. The accuracy of SICUS to preoperatively detect number, site, and length of strictures, fistulas, and abscesses was compared with surgical and pathological findings by kappa statistics.
SICUS identified at least one stricture in 39/40 and excluded it in 9/9 (97.5% sensitivity, 100% specificity, k = 0.93); two or more strictures in 9/12 (75% sensitivity, 100% specificity, k = 0.78). The agreement by k-statistics between SICUS and surgery in identifying proximal and distal small intestine site of stricture was 1 and 0.92, respectively. The extension of strictures was 6.8 ± 5.4 cm at surgery, 6.6 ± 5.4 cm at SICUS (NS). Fistulas were correctly identified in 27/28 patients and excluded in 19/21 patients (96% sensitivity, 90.5% specificity, k = 0.88). Intraabdominal abscesses were correctly detected in 10/10 patients and excluded in 37/39 patients (100% sensitivity, 95% specificity, k = 0.89).
SICUS is an accurate method for the detection of small intestinal complications in CD. Noninvasive SICUS is valuable as a primary investigative method for evaluating and planning proper treatment in patients with severe CD of the small bowel. (Inflamm Bowel Dis 2011;)