Clinical Endoscopy

  • 제55권4호
  • /
  • Pages.532-539
  • /
  • 2022
  • /
  • 2234-2400(pISSN)
  • /
  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지
DOI QR코드

DOI QR Code

Capsule enteroscopy versus small-bowel ultrasonography for the detection and differential diagnosis of intestinal diseases

  • Luca Elli (Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico) ;
  • Erica Centorrino (Department of Pathophysiology and Transplantation, University of Milan) ;
  • Andrea Costantino (Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico) ;
  • Maurizio Vecchi (Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico) ;
  • Stefania Orlando (Department of Pathophysiology and Transplantation, University of Milan) ;
  • Mirella Fraquelli (Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico)
  • 투고 : 2021.08.27
  • 심사 : 2022.02.25
  • 발행 : 2022.07.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: Capsule enteroscopy (CE) and intestinal ultrasonography (IUS) are techniques that are currently used for investigating small-bowel (SB) diseases. The aim of this study was to compare the main imaging findings and the lesion detection rate (LDR) of CE and IUS in different clinical scenarios involving the SB. Methods: We retrospectively enrolled patients who underwent CE and IUS for obscure gastrointestinal bleeding (OGIB), complicated celiac disease (CeD), and suspected or known inflammatory bowel disease (IBD). We evaluated the LDR of both techniques. The accuracy of IUS was determined using CE as the reference standard. Results: A total of 159 patients (113 female; mean age, 49±19 years) were enrolled. The LDR was 55% and 33% for CE and IUS (p<0.05), respectively. Subgroup analysis showed that the LDR of CE was significantly higher than that of IUS in patients with OGIB (62% vs. 14%, p<0.05) and CeD (55% vs. 35%, p<0.05). IUS showed a similar LDR to CE in patients with suspected or known IBD (51% vs. 46%, p=0.83). Conclusions: CE should be preferred in cases of OGIB and CeD, whereas IUS should be considered an early step in the diagnosis and follow-up of IBD even in patients with a proximal SB localization of the disease.

키워드

과제정보

The authors are thankful to the members of the Center for Prevention and Diagnosis of Celiac Disease of Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (Milan) for previous data storage.

참고문헌

  1. Monkemuller K. Should we illuminate the black box of the small bowel mucosa from above or below? Clin Gastroenterol Hepatol 2012;10:917-919.
  2. Eliakim R, Carter D. Endoscopic assessment of the small bowel. Dig Dis 2013;31:194-198.
  3. Fidler JL, Goenka AH, Fleming CJ, et al. Small bowel imaging: computed tomography enterography, magnetic resonance enterography, angiography, and nuclear medicine. Gastrointest Endosc Clin N Am 2017;27:133-152.
  4. Pennazio M, Spada C, Eliakim R, et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2015;47:352-376.
  5. Maconi G, Bianchi Porro G. Ultrasound of the gastrointestinal tract. 2nd ed. Berlin, Heidelberg: Springer; 2014.
  6. Wale A, Pilcher J. Current role of ultrasound in small bowel imaging. Semin Ultrasound CT MR 2016;37:301-312.
  7. Parente F, Maconi G, Bollani S, et al. Bowel ultrasound in assessment of Crohn's disease and detection of related small bowel strictures: a prospective comparative study versus x ray and intraoperative findings. Gut 2002;50:490-495.
  8. Fraquelli M, Colli A, Casazza G, et al. Role of US in detection of Crohn disease: meta-analysis. Radiology 2005;236:95-101.
  9. Nylund K, Hausken T, Odegaard S, et al. Gastrointestinal wall thickness measured with transabdominal ultrasonography and its relationship to demographic factors in healthy subjects. Ultraschall Med 2012;33:E225-E232.
  10. Nylund K, Maconi G, Hollerweger A, et al. EFSUMB recommendations and guidelines for gastrointestinal ultrasound: part 1: examination techniques and normal findings (long version). Ultraschall Med 2017;38:e1-15.
  11. Fraquelli M, Castiglione F, Calabrese E, et al. Impact of intestinal ultrasound on the management of patients with inflammatory bowel disease: how to apply scientific evidence to clinical practice. Dig Liver Dis 2020;52:9-18.
  12. Nylund K, Odegaard S, Hausken T, et al. Sonography of the small intestine. World J Gastroenterol 2009;15:1319-1330.
  13. Fraquelli M, Colli A, Colucci A, et al. Accuracy of ultrasonography in predicting celiac disease. Arch Intern Med 2004;164:169-174.
  14. Branchi F, Locatelli M, Tomba C, et al. Enteroscopy and radiology for the management of celiac disease complications: time for a pragmatic roadmap. Dig Liver Dis 2016;48:578-586.
  15. Marmo R, Rotondano G, Piscopo R, et al. Meta-analysis: capsule enteroscopy vs. conventional modalities in diagnosis of small bowel diseases. Aliment Pharmacol Ther 2005;22:595-604.
  16. Aloi M, Di Nardo G, Romano G, et al. Magnetic resonance enterography, small-intestine contrast US, and capsule endoscopy to evaluate the small bowel in pediatric Crohn's disease: a prospective, blinded, comparison study. Gastrointest Endosc 2015;81:420-427.
  17. Kopylov U, Yung DE, Engel T, et al. Diagnostic yield of capsule endoscopy versus magnetic resonance enterography and small bowel contrast ultrasound in the evaluation of small bowel Crohn's disease: systematic review and meta-analysis. Dig Liver Dis 2017;49:854-863.
  18. Carter D, Katz LH, Bardan E, et al. The accuracy of intestinal ultrasound compared with small bowel capsule endoscopy in assessment of suspected Crohn's disease in patients with negative ileocolonoscopy. Therap Adv Gastroenterol 2018;11:1756284818765908.
  19. Orlando S, Fraquelli M, Coletta M, et al. Ultrasound elasticity imaging predicts therapeutic outcomes of patients with Crohn's disease treated with anti-tumour necrosis factor antibodies. J Crohns Colitis 2018;12:63-70.
  20. Rezapour M, Amadi C, Gerson LB. Retention associated with video capsule endoscopy: systematic review and meta-analysis. Gastrointest Endosc 2017;85:1157-1168.e2.