Non-invasive diagnosis and grading of postsurgical endoscopic recurrence in Crohn's disease José María Paredes, Tomás Ripollés, Xavier Cortés, María.

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Presentation transcript:

Non-invasive diagnosis and grading of postsurgical endoscopic recurrence in Crohn's disease José María Paredes, Tomás Ripollés, Xavier Cortés, María Dolores Reyes, Antonio López, María Jesús Martínez, Eduardo Moreno- Osset Journal of Crohn's and Colitis Volume 4, Issue 5, Pages 537-545 (November 2010) DOI: 10.1016/j.crohns.2010.03.002 Copyright © 2010 European Crohn's and Colitis Organisation Terms and Conditions

Figure 1 Longitudinal US scan of the abdomen in 43-year old female with previous ileocolonic resection and severe endoscopic grade in the ileum. A) B-mode US scan demonstrates ileocolonic anastomosis with thickening of a short segment of the neoterminal ileum (arrows). Colon is normal (C). B) Colour Doppler sonogram of the same loop shows severe vascularity (grade 3). Journal of Crohn's and Colitis 2010 4, 537-545DOI: (10.1016/j.crohns.2010.03.002) Copyright © 2010 European Crohn's and Colitis Organisation Terms and Conditions

Figure 2 99mTc-HMPAO scintigraphy after 120minutes injection of labelled leucocyte, in 43-year old female with severe endoscopic recurrence. Abnormal (similar liver and spleen) uptake is seen in the neoterminal ileum (arrow). Journal of Crohn's and Colitis 2010 4, 537-545DOI: (10.1016/j.crohns.2010.03.002) Copyright © 2010 European Crohn's and Colitis Organisation Terms and Conditions

Figure 3 ROC curve showing the diagnostic accuracy for the sonographic variables, scintigraphic uptake grade 2 or 3 and combining both techniques parietal thickness of neoterminal ileum >5mm and/or LLS grade 2 or 3 for the detection of moderate-severe endoscopic recurrence. A) Sonographic variables: parietal thickness of neoterminal ileum >5mm (); Colour Doppler flow grade 2 or 3 (); parietal thickness of neoterminal ileum >5mm and/or colour Doppler flow grade 2 or 3 (). B) Scintigraphic uptake grade 2 or 3 () and combining both techniques (). Journal of Crohn's and Colitis 2010 4, 537-545DOI: (10.1016/j.crohns.2010.03.002) Copyright © 2010 European Crohn's and Colitis Organisation Terms and Conditions