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13.04.2018 | Original Article

Detecting inflammation in inflammatory bowel disease — how does ultrasound compare to magnetic resonance enterography using standardised scoring systems?

verfasst von: Joy L. Barber, Alexsandra Zambrano-Perez, Øystein E. Olsen, Fevronia Kiparissi, Mila Baycheva, Daniela Knaflez, Neil Shah, Tom A. Watson

Erschienen in: Pediatric Radiology | Ausgabe 6/2018

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Abstract

Background

Magnetic resonance enterography (MRE) is the current gold standard for imaging in inflammatory bowel disease, but ultrasound (US) is a potential alternative.

Objective

To determine whether US is as good as MRE for the detecting inflamed bowel, using a combined consensus score as the reference standard.

Materials and methods

We conducted a retrospective cohort study in children and adolescents <18 years with inflammatory bowel disease (IBD) at a tertiary and quaternary centre. We included children who underwent MRE and US within 4 weeks. We scored MRE using the London score and US using a score adapted from the METRIC (MR Enterography or Ultrasound in Crohn’s Disease) trial. Four gastroenterologists assessed an independent clinical consensus score. A combined consensus score using the imaging and clinical scores was agreed upon and used as the reference standard to compare MRE with US.

Results

We included 53 children. At a whole-patient level, MRE scores were 2% higher than US scores. We used Lin coefficient to assess inter-observer variability. The repeatability of MRE scores was poor (Lin 0.6). Agreement for US scoring was substantial (Lin 0.95). There was a significant positive correlation between MRE and clinical consensus scores (Spearman’s rho = 0.598, P=0.0053) and US and clinical consensus scores (Spearman’s rho = 0.657, P=0.0016).

Conclusion

US detects as much clinically significant bowel disease as MRE. It is possible that MRE overestimates the presence of disease when using a scoring system. This study demonstrates the feasibility of using a clinical consensus reference standard in paediatric IBD imaging studies.

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Titel: Detecting inflammation in inflammatory bowel disease — how does ultrasound compare to magnetic resonance enterography using standardised scoring systems?
verfasst von: Joy L. Barber
Alexsandra Zambrano-Perez
Øystein E. Olsen
Fevronia Kiparissi
Mila Baycheva
Daniela Knaflez
Neil Shah
Tom A. Watson
Publikationsdatum: 13.04.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Radiology / Ausgabe 6/2018
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-018-4084-1

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Detecting inflammation in inflammatory bowel disease — how does ultrasound compare to magnetic resonance enterography using standardised scoring systems?