Comparative Study Of Trans-abdominal Ultrasonography And Computed Tomography Enterography In The Diagnosis Of Crohn’s Disease

ObjectiveTo investigate the diagnostic value of trans-abdominal ultrasound in Crohn’s disease(CD)and compared to computed tomography enterography(CTE).MethodsFrom May 2015 to September 2016,73 consecutive CD patients,diagnosesed at the Department of Gastroenterologyin Peking Union Medical College Hospital,were enrolled in this study.All the patients underwent complete trans-abdominal ultrasound and enhanced CTE examinations.The data was analyzed by the chi-square test.ResultsThe US and CTE appearance of one patient were normal.A total of 139 lesions in 73 Crohn’s disease patients were included.It included that colon lesions(9/73,12.5%),small bowel lesions(17/73,23.6%),simultaneous lesions of ileum and colon(32/73,44.5%),and surgery anastomotic lesions(14/73,19.4%).The overall sensitivity in detecting lesions limited to small bowel were 98%for US,100%for CTE,respectively.The overall sensitivity in detecting colon lesions were 97.6%for US,100%for CTE,respectively.The sensitivity in the diagnosis of ileal type and colonic type were 100%for US and CTE.The sensitivity in the diagnosis of ileocolonic type was 93.8%for US,100%for CTE,respectively.The per-bowel-segments sensitivity of US was100%for jejunum;98%for ileal lesions;100%for ascendingcolon;90.9%for transversecolon;94.1%for descendingcolon;and 72.7%for sigmoidcolon,respectively.The sensitivities in detecting CD fistula was 95.7%and 93.6%in US and CTE,respectively.Both the sensitivities in detecting CD abscess of US and CTE were 100%.There was no significant difference in detectionrate of abscess between US and CTE(P>0.05).The sensitivities in detecting CD abscess was 100%in US.ConclusionsUS is a valuable technique for defining anatomic location and extension of CD as well as detecting fistula and abscess complications.A high consistency was achieved between US and CTE.It may be therefore regarded as a useful imaging procedure in the diagnostic work up of CD.Objective:To investigate the character of trans-abdominal ultrasonographic features in Intestinal Behcet’s Disease(BD).Methods:According to the International Study Group for Behcet’s Disease diagnostic criter,15 cases ofclinical and ultrasonic data of intestinal Behcet’sdisease were statistically analyzed with theapplication of SPSS 23.0.Results:Digestive system symptoms of the 15 patients emerged at the mean age of 35.A total of 36 lesions in 15 intestinal patients were included.Ileocecal was mostly probable involved,with the ratio of 33%(12/36),followed by terminal ileum(28%,10/36),ascending colon(19%,7/36),transverse colon(8%,3/36),descending colon(6%,2/36)and urgery anastomotic lesions(6%,2/36).The sensitivity and specificity of USin detecting lesions were 88.6%and100%,respectively.All of the 15 patients had a thickened bowel wall.The average thickness of bowel wall was about 7 mm(4-12mm).The intestinal structure is not clear or disappear in 46.7%(7/15)cases,the other 53.3%is still distinctive.Ulcers were detected by trans-abdominal ultrasound in 73.3%cases,including single ulcer(n=6)and multiple ulcers(n=5).3 of the single ulcer cases had large ulcer,with a diameter of 20-37mm.US found 6 lesions of fistula,confirmed by CTE or clinical diagnosis.By means of the endoscopy,92.3%(12/13)of the 13 patients with complete results had ulcers,in which 4 cases with solitary large ulcers,5 with single or multiple irregular ulcers and 3 with circumferential ulcer.One case in remission hadno positive presentation under endoscopy,the same as US.There was one false-negative detection result by US,and the overall sensitivity in detecting ulcer was 91.7%for US.Conclusions:Trans-abdominal US is a valuable technique showing involvement lesions,ulcers and fistulas of intestinal BD clearly.US can be a useful imaging method in the clinical diagnostic of intestinal BD.