Journal Article

Combined gray scale ultrasonography and doppler diagnostic tools with strain elastography in assessment of inflammatory bowel disease in pediatrics patients

Ali, Hadeel Mohamed Seif Eldin, Eskander, Ayman Emil, Mahmoud, Reham Osama, Mohamed, Enas Mamdooh Awad Allah

2024

Overview

Background Intestinal changes in inflammatory bowel disease (IBD) are frequently observed on ultrasound. Invasive diagnostic procedures are often employed to differentiate between the main types of IBD and detect complications. Ultrasound Strain Elastography (SE) is a promising non-invasive technique for detecting intestinal changes and assessing inflammatory activity in pediatric IBD. Aim of the study This research aims to evaluate the diagnostic performance of conventional ultrasound, color Doppler, and SE in assessing inflammatory bowel disease in pediatric patients, both separately and in combination as additional tools. Patients and methods Forty patients (18 females and 22 males) initially diagnosed with IBD through clinical and endoscopic biopsy, along with 20 healthy controls, underwent conventional ultrasound, color Doppler, SE, and laboratory evaluations, including CBC, ESR, CRP, Fecal calprotectin, and assessment of IBD activity using PIBDAI. Results Conventional ultrasound, color Doppler, and SE significantly contributed to detecting disease activity and intestinal changes in IBD ( p  < 0.001; 95% CI 0.79–1.100), demonstrating better sensitivity in combination compared to each method individually. The combined approach showed 100% sensitivity, 84% specificity, 78.6% precision (Positive Predictive Value), 100% Negative Predictive Value, and an overall accuracy of 92%. Conclusion The addition of Color Doppler and SE parameters to grayscale ultrasound provides diagnostic value comparable to endoscopy, histopathology, and laboratory markers in detecting inflammatory activity and intestinal changes in IBD. This combined approach can help avoid unnecessary invasive techniques for follow-up.

• Publisher: Springer International Publishing,Springer Nature B.V
• Subject: Accuracy / Adolescent / Anemia / Child / Colon / Color / Crohn's disease / Diarrhea / Elasticity Imaging Techniques - methods / Endoscopy / Female / Gray scale / Humans / Inflammation / Inflammatory bowel disease / Inflammatory Bowel Diseases - diagnostic imaging / Intestines - diagnostic imaging / Laboratories / Male / Medicine / Medicine & Public Health / Original Paper / Pathology / Performance evaluation / Sensitivity / Sensitivity and Specificity / Small intestine / Ultrasonic imaging / Ultrasonography - methods / Ultrasonography, Doppler, Color - methods / Ultrasound / Validity