KMID : 0191120230380290219
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Journal of Korean Medical Science 2023 Volume.38 No. 29 p.219 ~ p.219
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Contrast-Enhanced Ultrasonography for the Evaluation of Crohn¡¯s Disease in Pediatric Patients
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Yoon Hae-Sung
Kim Ji-Soo Lim Hyun-Ji Lee Mi-Jung Lim Hye-Ji Noh Ji-Hye Park So-Won
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Abstract
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Background : Contrast-enhanced ultrasonography (CEUS) of the bowel wall has been suggested as an alternative imaging modality for the follow-up of children with Crohn¡¯s disease. To demonstrate the feasibility and clinical usefulness of CEUS in the estimation of Crohn¡¯s disease activity in children with endoscopy as the reference standard.
Method : In this prospective study, 30 pediatric patients with Crohn¡¯s disease (24 males and 6 females; median age 14 years) underwent CEUS from December 2020 to August 2021. The simple endoscopic score for Crohn¡¯s disease, pediatric Crohn¡¯s disease activity index, serologic inflammatory markers, fecal calprotectin and CEUS perfusion parameters were assessed and compared between the inactive and active group based on endoscopic findings.
Results : CEUS was performed successfully in all 30 patients. Two patients showed mild adverse side effects such as temporary dysosmia. The active Crohn¡¯s disease group showed higher erythrocyte sedimentation rate (mm/hr) (13.0 vs. 2.0, P = 0.003), C-reactive protein (mg/dL) (4.7 vs. 0.55, P = 0.018) and fecal calprotectin (mcg/g) (1,503 vs. 237.5, P = 0.005). Among the quantitative parameters for CEUS, the mean gradient to the peak value was higher in the active group (1.18 vs. 0.93, P = 0.034). The sensitivity and specificity of the mean gradient to the peak value for predicting active Crohn¡¯s disease was 55.6% and 83.3%, respectively, with a cut-off of 1.09 (P = 0.015).
Conclusion : CEUS can be a safe and specific diagnostic modality for Crohn¡¯s disease activity in children. Among quantitative CEUS parameters, the mean gradient to the peak value could be used to differentiate active and inactive Crohn¡¯s disease.
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KEYWORD
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Contrast Enhanced Ultrasound, Crohn¡¯s Disease, Pediatric
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