Kerri Novak MD, Abstract Co-Author: Research Grant, Abbott Laboratories Consultant, Abbott Laboratories Speakers Bureau, Merck KgaA

Amelia Kellar MSc, Abstract Co-Author: Nothing to Disclose

Gilaad Kaplan, Abstract Co-Author: Advisory Board, Abbott Laboratories Advisory Board, UCB SA Advisory Board, Merck & Co, Inc

Remo Panaccione MD, Abstract Co-Author: Research Consultant, Abbott Laboratories

Jennifer DeBruyn MD,MSc, Abstract Co-Author: Advisory Board, Johnson & Johnson

Stephanie R. Wilson MD, Presenter: Research Grant, Lantheus Medical Imaging, Inc Research Grant, Abbott Laboratories Consultant, Lantheus Medical Imaging, Inc

Monitoring inflammatory activity is key to prevent disability in Crohns disease. Endoscopy requires anesthetic and children are vulnerable to adverse effects of ionizing radiation from CT. Routine access to MR is limited. Transabdominal ultrasound (US) is safe, accessible, well tolerated and inexpensive. The goal of this study was to evaluate the accuracy and reliability of US in the detection of inflammation in IBD in children.

110 children were retrospectively identified in a Calgary outpatient ultrasound unit and only patients with endoscopy within 3 months had comparison parameters. Inflammatory US parameters included: bowel wall thickness, mesenteric fat, hyperemia and lymphadenopathy. Mann-Whitney U-Tests were used to compare endoscopic and sonographic parameters. Signed Rank and Bowker tests were used to compare disease severity and extent of disease. Unpaired T-tests and Wilcoxon signed-ranked tests examined inflammatory US parameters. Sensitivity and specificity of sonography for detecting inflammation was analyzed using 2x2 statistical tables.

A total of 110 patients were identified: 68.1% (n=75) were diagnosed with IBD, and 31.8% (n=28) were controls. Of those in the IBD group: 80% (n=60) had Crohn disease, 17.3% had ulcerative colitis and 2.7% (n=2) had indeterminate colitis. There were no significant differences between US inflammatory parameters and endoscopy (p>0.05). Significant differences were found between parameters in IBD patients compared to control patients as assessed by US (p<0.05). US sensitivity and specificity analysis was completed for both terminal ileum (TI) and colonic disease. US in remissive and mild disease had a sensitivity of 78.5% for TI and 76.2% for colonic disease. Specificity for remissive and mild disease was 92.8% for TI and 92.3% for colonic disease. Moderate and severe disease was identified with a sensitivity of 100% for TI and 92.3% for colonic disease, specificity of 73% for TI and 76.2% for disease within the colon.

US is effective in distinguishing remissive, mild, moderate and severe IBD.

US is a useful imaging modality for monitoring pediatric IBD.

Novak, K, Kellar, A, Kaplan, G, Panaccione, R, DeBruyn, J, Wilson, S, A Retrospective Analysis of the Use of Transabdominal Ultrasound in Monitoring Pediatric Inflammatory Bowel Disease.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12030537.html