Background and aims Small intestine contrast ultrasonography (SICUS) is an emerging, non-invasive technique which accurately assesses small bowel lesions associated with Crohn’s disease (CD) in adult patients, without exposure to medical radiation. We report our 5 year experience in a paediatric cohort.
Methods Patients with suspected or established CD who underwent SICUS were identified and radiological findings collated. SICUS was compared to conventional transabdominal ultrasound (TUS), ileocolonoscopy and magnetic resonance enterography (MRE). Accuracy and agreement of SICUS in detecting small bowel lesions and CD-related complications was assessed using kappa (κ) coefficient statistics.
Results 93 patients (median age 16 years, range 2–20, 49 male) underwent SICUS; 58 had suspected and 35 established CD. In suspected CD, sensitivity and specificity of SICUS in detecting CD small bowel lesions were 81.82% and 100% and TUS 85.71% and 87.50%, respectively. In established CD, sensitivity and specificity of SICUS were 83.33% and 100% and TUS 80.00% and 100%, respectively. Agreement with ileocolonoscopy was fair for the presence of lesions (SICUS, κ=0.38, TUS, κ=0.31). Agreement between SICUS and ileocolonoscopy was good for detecting strictures (κ=0.66) with a sensitivity of 100% and specificity of 97.62%. Comparing SICUS and TUS with MRE, agreement for the presence of lesions was κ=0.63 and 0.53, respectively. Agreement between SICUS and MRE was good for detecting strictures (κ=0.77) and fair for assessing dilatation (κ=0.45).
Conclusions SICUS offers a promising radiation-free, low cost alternative for diagnosing and monitoring paediatric CD small bowel complications. Its wider use should be adopted.