IBD and New Assessment US Score

 

ABSTRACT

Purpose

The purpose of this study is to propose new ultrasound scores to assess inflammatory bowel disease (IBD) activity and to analyze their accuracy in assessing disease severity. In addition to this, to validate that intestinal ultrasound can be used as a follow-up tool for the assessment of IBD.

Methods

One hundred and thirty-six adult IBD patients who underwent intestinal ultrasound. Patients were divided into two groups based on colonoscopic findings: 93 patients with UC, 43 patients with CD. UC patients and CD patients were divided into active and inactive groups based on colonoscopic findings, respectively. After forming scores, cut-off values, sensitivity, and specificity were calculated using receiver operating characteristic (ROC) analysis, respectively.

Results

Both in UC patients and in CD patients, bowel wall thickness (BWT) and vascular index (VI) were much higher in the active group compared with the inactive group, CEUS mode III, IV, CDFI grades 3–4, fat wrapping, and lost stratification were more likely to imply active disease. In UC patients only, Young's modulus value was much higher in the active group compared with the inactive group.

Conclusion

The new intestinal ultrasound scores can be used to assess UC and CD activity and may be useful in identifying severe endoscopic activity in IBD.

AA possibility and US of non visualized appendix

 

ABSTRACT

Background

Ultrasonography (USG), which is used as the first step in the diagnosis of acute appendicitis (AA), sometimes cannot visualize the appendix. The aim of this study was to retrospectively analyze the clinical, imaging, and pathology results of these cases and to provide information to clinicians about the next step to be taken.

Methods

The study was performed retrospectively between January 1, 2021 and December 31, 2021. Patients with a prediagnosis of AA who underwent USG as the first-line imaging modality and in whom the appendix could not be visualized were included. Imaging, clinical, and pathology results of the patients were analyzed, and the study was completed by comparing patients with and without computed tomography (CT) scans as well as patients with and without AA diagnosis.

Results

The study included 176 patients aged 18–89 years, 63 (35.8%) of whom were male and 113 (64.2%) female. The mean age was 37.5 ± 17.8 years. CT was not performed in 97 patients (55.1%), while it was performed in 79 patients (44.9%). Of the patients, 121 (68.7%) were discharged and 55 (31.2%) were hospitalized. Of the patients who were hospitalized, 36 (20.5%) received medical treatment and 19 (10.7%) received surgical treatment. Fifteen patients (8.5%) were pathologically diagnosed with AA. Two patients (1.1%) who were discharged without CT were subsequently diagnosed with AA. The white blood cell (WBC) count of patients operated on for AA was 13.4 ± 3.9 × 103/mL, while the WBC count of the other patients was 10.3 ± 4.2 × 103/mL (p = 0.009). The proportion of patients with an Alvarado score of ≥ 6 was 80% in patients diagnosed with AA, while this rate was 4.3% in other patients (p < 0.001).

Conclusions

In cases of a nonvisualized appendix on USG, the absence of leukocytosis and an Alvarado score below 6 may suggest a reduced likelihood of AA. Consequently, further investigations, such as CT and magnetic resonance imaging, could be avoided.