Abstract

BACKGROUND AND AIMS: Intestinal ultrasound (IUS) performed by experts is a valuable tool for the diagnostic work-up and monitoring of Crohn's disease (CD). However, concern about insufficient training and perceived high inter-observer variability limit the adoption of IUS in CD. We examined the diagnostic accuracy of trainee-performed IUS in patients with suspected CD.

METHOD: Patients recruited to a prospective trial investigating the diagnostic accuracy of magnetic resonance enterocolonography (MREC) in patients with clinically suspected CD underwent IUS performed by trainees. The primary end-point was IUS per-patient sensitivity and specificity for ileocolonic CD determined by ileocolonoscopy.

RESULTS: 129 patients with clinically suspected CD and a complete IC and IUS were included in the analysis. IUS detected signs of CD in 49 cases (small bowel 31, colon 15, small bowel, and colon 3). The sensitivity and specificity for detection of ileocolonic CD by trainee performed IUS improved during the first to the second half of the study period from 57.1% (CI 34.0-78.2) to 73.1% (CI 52.2-88.4) and 76.5% (CI 58.8-89.3) to 89.7% (CI 72.6-97.8). The overall sensitivity and specificity of diagnosing CD with IUS were 65.4% (CI 50.9-78.0) and 80.5% (CI 69.9-88.7). There was no difference in diagnostic performance between IUS and MREC for the detection of CD.

CONCLUSION: Trainees improved during the study, and IUS performance in disease detection corresponded to expert-evaluated MREC. Registered at ClinicalTrials.gov (NCT03134586).

Original languageEnglish
JournalScandinavian Journal of Gastroenterology
Volume58
Issue number12
Pages (from-to)1405-1411
ISSN0036-5521
DOIs
Publication statusPublished - 2023

Keywords

  • Crohn’s disease
  • diagnostic imaging
  • intestinal ultrasound
  • magnetic resonance imaging
  • Prospective Studies
  • Colon/diagnostic imaging
  • Humans
  • Sensitivity and Specificity
  • Intestine, Small/pathology
  • Magnetic Resonance Imaging/methods
  • Crohn Disease/diagnostic imaging

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