Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Contrast-Enhanced Ultrasound and Shear Wave Elastography Evaluation of Crohn's Disease Activity in Three Adolescent Patients

  • Thimm, Matthew A (The Johns Hopkins University School of Medicine) ;
  • Cuffari, Carmen (Division of Pediatric Gastroenterology, Johns Hopkins Hospital) ;
  • Garcia, Alejandro (Division of Pediatric Surgery, Johns Hopkins Hospital) ;
  • Sidhu, Sarah (Division of Pediatric Gastroenterology, Johns Hopkins Hospital) ;
  • Hwang, Misun (Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania)
  • Received : 2018.05.14
  • Accepted : 2018.07.13
  • Published : 2019.05.15
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Abstract

Characterizing inflammation and fibrosis in Crohn's disease (CD) is necessary to guide clinical management, but distinguishing the two remains challenging. Novel ultrasound (US) techniques: contrast-enhanced US (CEUS) and shear wave elastography (SWE) offer great potential in evaluating disease activity in pediatric patients. Three patients ages 16 to 20 with known CD underwent CEUS and SWE to characterize bowel wall inflammation and fibrosis. Magnetic resonance enterography, endoscopy, or surgical pathology findings are also described when available. The patients' disease activity included acute inflammation, chronic inflammation with stricture formation, and a fibrotic surgical anastomosis without inflammation. CEUS was useful in determining the degree of inflammation, and SWE identified bowel wall fibrosis. Used together these techniques allow for better characterization of the degree of fibrosis and inflammation in bowel strictures. With further validation CEUS and SWE may allow for improved characterization of bowel strictures and disease flares in pediatric patients suffering from CD.

Keywords

References

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