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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Crohns+Colitis
2016 ; 10
(3
): 354-62
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Contrast-enhanced Ultrasound for Detection of Crohn s Disease Activity:
Systematic Review and Meta-analysis
#MMPMID26507861
Serafin Z
; Bia?ecki M
; Bia?ecka A
; Sconfienza LM
; K?opocka M
J Crohns Colitis
2016[Mar]; 10
(3
): 354-62
PMID26507861
show ga
BACKGROUND AND AIMS: Reports on imaging of active Crohn's disease (aCD) using
contrast-enhanced ultrasound (CEUS) are encouraging. However, the statistical
power of most published papers is limited due to the small size of the patient
groups included. This study was performed to verify the diagnostic value of CEUS
in detecting aCD. METHODS: A systematic literature search was performed by two
independent reviewers for articles on the test characteristics of CEUS for the
identification of aCD. The quality of the analysed studies was evaluated using a
quality assessment tool for diagnostic accuracy studies (QUADAS-2). Pooling was
performed using a diagnostic random-effect model and bivariate analysis. RESULTS:
Eight articles were included in the final analysis, with a total of 332 patients.
There was no significant publication bias. Significant heterogeneity was found
regarding CEUS methodology and sonographic definitions of aCD. In a bivariate
analysis, pooled sensitivity was 0.94 (95% CI 0.87-0.97) and pooled specificity
was 0.79 (95% CI 0.67-0.88). Spearman correlation statistics presented no
significant diagnostic threshold effect (r = 0.12, p > 0.9). Subgroup analysis
showed that relative intestine wall enhancement had the highest diagnostic value
(area under the curve 94%), while the presence of enhancement and analysis of the
slope were less useful (area under the curve 91 and 90%, respectively).
CONCLUSIONS: CEUS presents good sensitivity and moderate specificity in the
detection of the aCD. Large-scale randomized trials with quantitative evaluation
of CEUS images are necessary to promote this technique in clinical practice.