Ultrasonography of the Colon in Pediatric Ulcerative Colitis: A Prospective, Blind, Comparative Study with Colonoscopy

Objectives To evaluate the usefulness of colonic ultrasonography (US) in assessing the extent and activity of disease in pediatric ulcerative colitis (UC) and to compare US findings with clinical and endoscopic features. Study design Consecutive pediatric patients (n = 60) with a diagnosis of UC and...

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Bibliographic Details
Published in:The Journal of pediatrics 2014-07, Vol.165 (1), p.78-84.e2
Main Authors: Civitelli, Fortunata, MD, Di Nardo, Giovanni, MD, PhD, Oliva, Salvatore, MD, Nuti, Federica, MD, PhD, Ferrari, Federica, MD, Dilillo, Anna, MD, Viola, Franca, MD, Pallotta, Nadia, MD, Cucchiara, Salvatore, MD, PhD, Aloi, Marina, MD, PhD
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Colitis, Ulcerative - diagnostic imaging
Colitis, Ulcerative - pathology
Colon - diagnostic imaging
Colon - pathology
Colonoscopy - methods
Double-Blind Method
Female
Humans
Male
Pediatrics
Prospective Studies
Ultrasonography, Doppler, Color - methods
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Summary:Objectives To evaluate the usefulness of colonic ultrasonography (US) in assessing the extent and activity of disease in pediatric ulcerative colitis (UC) and to compare US findings with clinical and endoscopic features. Study design Consecutive pediatric patients (n = 60) with a diagnosis of UC and suspected disease flare-up were prospectively enrolled; of these, 50 patients were eligible for the study. All underwent clinical evaluation, bowel US with color Doppler examination and colonoscopy. Blind US was performed the day before endoscopy in all patients. The US assessed variables were bowel wall thickness >3 mm, bowel wall stratification, vascularity, presence of haustra coli, and enlarged mesenteric lymph nodes. Results The endoscopic extent of disease was independently confirmed in 47 patients by US that yielded a 90% concordance with endoscopy (95% CI 0.82-0.96). Multiple regression analysis showed that US measurements with an independent predictive value of severity at endoscopy were increased bowel wall thickness ( P  
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2014.02.055