Crohn's disease at the small bowel imaging by the
ultrasound-enteroclysis.

J 2007

Crohn's disease at the small bowel imaging by the ultrasound-enteroclysis.

VÁLEK, Vlastimil, Petr KYSELA and Markéta VAVŘÍKOVÁ

Basic information

Original name

Crohn's disease at the small bowel imaging by the ultrasound-enteroclysis.

Name in Czech

Crohnova choroba tenkého střeva v obraze ultrazvukové enteroklýzy

Authors

VÁLEK, Vlastimil (203 Czech Republic, guarantor), Petr KYSELA (203 Czech Republic) and Markéta VAVŘÍKOVÁ (203 Czech Republic)

Edition

European journal of radiology, Ireland, Elsevier Science Ireland Ltd, 2007, 0720-048X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30000 3. Medical and Health Sciences

Country of publisher

Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 1.915

RIV identification code

RIV/00216224:14110/07:00032289

Organization unit

Faculty of Medicine

UT WoS

000246613700002

Keywords in English

Crohns disease; diagnostics;ultrasound ;enteroclysis;surgery;treatment;small intestine

Abstract

ORIG CZ

V originále

SUMMARY: Crohn's disease is more likely a systemic disease governed by a shift in the immune response, thus affecting the whole MALT system. Its treatment should be as conservative as possible and surgery is usually taking place after complications like indolent fistulations, stenoses, bleeding, or bowel perforation started. Standard radiological methods to check the extent of the disease are loaded either with certain radiation exposure (enteroclysis, CT) or lack standardization (ultrasound). The aim of this small study was to evaluate the worth of ultrasound-enteroclysis in detecting the extent and complications of the Crohn's disease in surgically treated patients. MATERIAL AND METHODS: Since 1997, when we started with the ultrasound-enteroclysis, 246 surgical performances were involved into our study. Out of them, 181 had conventional abdominal intestinal ultrasound as well as conventional enteroclysis within 1 week. Remaining 65 cases were diagnosed by the ultrasound-enteroclysis. Intestinal ultrasound was performed on the Ultramark 3000 HDI device with autofocussable convex 5 MHz and linear 7.5 MHz probes or nowadays ATL 5000 HDI, 7-12 MHz linear probe. No contrast enhancement was used. Enteroclysis was done with the Micropaque suspension diluted 1:1 with HP-7000 300 ml with its application rate up to 75 ml/min followed by HP-7000 solution 2000 ml, application rate of 120 ml/min. The patients with ultrasound-enteroclysis were applied HP 7000 solution only (2000 ml, rate 100ml/s) via an enteroclysis catheter. All investigations were video-recorded. RESULTS: Consent with the per-operative finding was reached in 162 from 181 enteroclyses and in 169 of 181 ultrasounds. Ultrasound-enteroclysis was precise in 61 cases from 65. Among these, 60 patients had the recurrence during the treatment proved by clinical and laboratory results. This re-activation was clearly revealed in 38 from 43 cases by enteroclysis, 41 from 43 by US and in 16 from 17 by ultrasound-enteroclysis. From 30 patients that developed acute complication non-responding to the conservative therapy (abscesses, fistulas and intestinal obstructions) there were 18 from 20 accurately diagnosed by enteroclysis, only 12 from 20 by US and 9 from 10 by US-enteroclysis. The differences were either statistically non-significant or there were too small numbers to give sensible statistical results, but low sensitivity of ultrasound in complications (p=0.05). CONCLUSION: US-enteroclysis seems to became the standard examination of patients with Crohn's disease mainly in those with unclear conventional ultrasound. The most important fact is that this examination significantly decreases the radiation load when maintaining high sensitivity. This is very important namely in patients with Crohn's disease that require life-long observation and repeated examinations. This examination is much more easy to standardize than the conventional US.

In Czech

Článek se zabývá přínosem nové metody - ultrazvukové enteroklýzy tenkého střeva, v diagnostice crohnovy choroby. Zdá se, že tato metoda je méně zatěžující než doposud užívané a spojuje v sobě výhody klasického UZ vyšetření střeva i klasické enteroklýzy jako dvojkontrastního vyšetření.

Citovat

VÁLEK, Vlastimil, Petr KYSELA and Markéta VAVŘÍKOVÁ. Crohn's disease at the small bowel imaging by the ultrasound-enteroclysis. European journal of radiology. Ireland: Elsevier Science Ireland Ltd, 2007, vol. 62, No 2, p. 153-9, 7 pp. ISSN 0720-048X.

@article{721874,
   author = {Válek, Vlastimil and Kysela, Petr and Vavříková, Markéta},
   article_location = {Ireland},
   article_number = {2},
   keywords = {Crohns disease; diagnostics;ultrasound ;enteroclysis;surgery;treatment;small intestine},
   language = {eng},
   issn = {0720-048X},
   journal = {European journal of radiology},
   title = {Crohn's disease at the small bowel imaging by the ultrasound-enteroclysis.},
   volume = {62},
   year = {2007}
}

TY  - JOUR
ID  - 721874
AU  - Válek, Vlastimil - Kysela, Petr - Vavříková, Markéta
PY  - 2007
TI  - Crohn's disease at the small bowel imaging by the ultrasound-enteroclysis.
JF  - European journal of radiology
VL  - 62
IS  - 2
SP  - 153-9
EP  - 153-9
PB  - Elsevier Science Ireland Ltd
SN  - 0720048X
KW  - Crohns disease
KW  - diagnostics;ultrasound ;enteroclysis;surgery;treatment;small intestine
N2  - SUMMARY: Crohn's disease is more likely a systemic disease governed by a shift in the immune response, thus affecting the whole MALT system. Its treatment should be as conservative as possible and surgery is usually taking place after complications like indolent fistulations, stenoses, bleeding, or bowel perforation started. Standard radiological methods to check the extent of the disease are loaded either with certain radiation exposure (enteroclysis, CT) or lack standardization (ultrasound). The aim of this small study was to evaluate the worth of ultrasound-enteroclysis in detecting the extent and complications of the Crohn's disease in surgically treated patients. MATERIAL AND METHODS: Since 1997, when we started with the ultrasound-enteroclysis, 246 surgical performances were involved into our study. Out of them, 181 had conventional abdominal intestinal ultrasound as well as conventional enteroclysis within 1 week. Remaining 65 cases were diagnosed by the ultrasound-enteroclysis. Intestinal ultrasound was performed on the Ultramark 3000 HDI device with autofocussable convex 5 MHz and linear 7.5 MHz probes or nowadays ATL 5000 HDI, 7-12 MHz linear probe. No contrast enhancement was used. Enteroclysis was done with the Micropaque suspension diluted 1:1 with HP-7000 300 ml with its application rate up to 75 ml/min followed by HP-7000 solution 2000 ml, application rate of 120 ml/min. The patients with ultrasound-enteroclysis were applied HP 7000 solution only (2000 ml, rate 100ml/s) via an enteroclysis catheter. All investigations were video-recorded. RESULTS: Consent with the per-operative finding was reached in 162 from 181 enteroclyses and in 169 of 181 ultrasounds. Ultrasound-enteroclysis was precise in 61 cases from 65. Among these, 60 patients had the recurrence during the treatment proved by clinical and laboratory results. This re-activation was clearly revealed in 38 from 43 cases by enteroclysis, 41 from 43 by US and in 16 from 17 by ultrasound-enteroclysis. From 30 patients that developed acute complication non-responding to the conservative therapy (abscesses, fistulas and intestinal obstructions) there were 18 from 20 accurately diagnosed by enteroclysis, only 12 from 20 by US and 9 from 10 by US-enteroclysis. The differences were either statistically non-significant or there were too small numbers to give sensible statistical results, but low sensitivity of ultrasound in complications (p=0.05). CONCLUSION: US-enteroclysis seems to became the standard examination of patients with Crohn's disease mainly in those with unclear conventional ultrasound. The most important fact is that this examination significantly decreases the radiation load when maintaining high sensitivity. This is very important namely in patients with Crohn's disease that require life-long observation and repeated examinations. This examination is much more easy to standardize than the conventional US.
ER  -

VÁLEK, Vlastimil, Petr KYSELA and Markéta VAVŘÍKOVÁ. Crohn's disease at the small bowel imaging by the ultrasound-enteroclysis. \textit{European journal of radiology}. Ireland: Elsevier Science Ireland Ltd, 2007, vol.~62, No~2, p.~153-9, 7 pp. ISSN~0720-048X.

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