Z Gastroenterol 2011; 49 - P179
DOI: 10.1055/s-0031-1285451

Non-invasive assessment of Crohn's disease complications by High end ultrasound with SonoCT® and Harmonic Imaging – A new diagnostic approach with a high accuracy

H Neye 1, D Ensberg 1, P Rauh 1, U Peitz 2, G Treiber 2, P Malfertheiner 2, S Rickes 1
  • 1AMEOS Hospital St. Salvator Halberstadt, Department of Medicine, Halberstadt, Germany
  • 2Otto von Guericke University Magdeburg, Department of Gastroenterology, Hepatology and Infectiology, Magdeburg, Germany

Introduction: Currently, endoscopy, computed tomography or laparoscopy are the preferred techniques for assessing complications (stenosis, fistula, abscess) of Crohn's disease but these are invasive or utilizing ionizing radiation. Since patients with Crohn's disease may require frequent evaluation, there is a high need for a non-invasive method. In recent years, transabdominal ultrasound has been proposed as a method to assess Crohn's disease complications. The aim of this prospective study was to evaluate High end ultrasound with SonoCT® and Harmonic Imaging by blinded comparison with the current diagnostic standard.

Patients and methods: Fifty-eight patients (31 women, 27 men, median age 36.3 years) with confirmed Crohn's disease were prospectively investigated with High end ultrasound with SonoCT® and Harmonic Imaging (iU22, Philips Ultrasound, Bothell, USA) as well as endoscopy, computed tomography, clinical follow-up and/or surgery. Ultrasound was performed within 24 hours prior to the other examinations. All procedures were performed by experienced examiners who were blinded to the clinical data and other results. Defined ultrasound parameters were used to determine the sonographic observation.

Results: The study showed sensitivity, specificity, positive predictive value and negative predictive value of High end ultrasound with SonoCT® and Harmonic Imaging: 0.86; 0.90; 0.83 and 0.92 for stenoses, 0.78; 0.95; 0.86 and 0.91 for fistulas, 0.90; 0.99; 0.90 and 0.99 for abscesses. The accuracy was calculated: 88% for stenoses, 90% for fistulas and 97% for abscesses.

Conclusion: The accurate detection of intestinal complications is a major issue in the management of patients with Crohn's disease. In this prospective study we have evaluated the ability of High end ultrasound with SonoCT® and Harmonic Imaging to detect stenoses, fistulas, and abscesses. The results demonstrate an excellent accuracy of the High end ultrasound with SonoCT® and Harmonic Imaging in the diagnosis of complications in patients with Crohn's disease.