Introduction USS (Ultra sound scan) in experienced hands is good radiological modality in diagnosing, confirming or ruling out Crohn’s disease. USS is easy, cost effective and without risk of radiation as compared to CT (Computerised tomography) or MRI (Magnetic resonance imaging) scans. USS can be particularly useful in younger population with Crohn’s who may require repeated imaging.
We were interested to look at outcomes of USS of small bowel performed by dedicated GI (gastrointestinal) radiologist in our hospital.
Methods We audited efficacy of USS in patients with known, suspected or to exclude Crohn’s disease. A retrospective review of patient records using specialised electronic Medicorr and PACS databases was performed. Demographic information, diagnosis, procedural details and subsequent result of USS was entered into a Microsoft Access database and analysed using Microsoft Excel.
Results A total of 145 patients underwent USS of small bowel in 18 months. The average age was 40. There were 97 females and 48 males. USS was performed in fifty seven patients with known, twenty four suspected and in 64 patients to exclude Crohn’s disease. In known disease group thirty four (60%) had normal USS (these patients were in remission), and twenty three (40%) had USS findings consistent with active, small or large bowel disease, strictures, fistulating disease and abscesses.
For suspected group, 17 patients (70%) had normal and seven (30%) had features consistent with Crohn’s. Five of these positive scan patients had MRI scans. 2 MRI scans confirmed USS findings, 3 were normal and required endoscopic confirmation.
In exclusion group 64 had USS with 61 (95%) normal and 3(4%) abnormal. Findings of 3 abnormal scan showed gallbladder polyp, caecal thickening (colonoscopy confirmed caecal tumour) and non- specific ileitis with negative colonoscopy and histology.
Conclusion Our results show that USS is reliable and as good as other imaging if done by experienced radiologist with special interest in GI radiology. USS is cost effective, readily available and free of radiation. It is cheap, portable, flexible and user- and patient-friendly. It can save cost and time required for CT and MRI scan especially in district general hospital.
We recommend utilising USS small bowel to assess disease activity in known cases and also to confirm or exclude the disease provided experienced GI radiologist is available.
References 1 Nylund K, Ødegaard S et al. Sonography of the small intestine. World J Gastroenterol 2009;15(11):1319–1330
2 Parente F, Greco S et al. Modern Imaging of crohn’s disease using bowel ultrasound. Inflamm Bowel Dis 2004; 10(4):452–461
Disclosure of Interest None Declared.
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