Contrast-enhanced ultrasound (CEUS) is rapidly emerging as a means of diagnosing Crohn’s disease in children instead of endoscopy, which has concerns about invasion of the large intestine.
It is in the limelight as an important diagnostic tool with the advantage of being non-invasive and inexpensive. In particular, it is the first domestic study to prove its effectiveness and increase its usability.
Contrast-enhanced ultrasound is emerging as an important tool for diagnosing Crohn’s disease in children.
On the 24th, the Journal of Korean Medical Science, an international journal of the Korean Medical Association, will publish the results of a study on the effectiveness of contrast-enhanced ultrasound in diagnosing Crohn’s disease in children.
Crohn’s disease is one of the chronic inflammatory bowel diseases, which has not yet been conquered, and its prevalence is increasing significantly, becoming a challenge in the medical world.
In particular, when a child suffers from Crohn’s disease, there is a growing awareness in that it greatly affects growth and development due to nutritional imbalance. This is why the importance of early diagnosis is emphasized.
Currently, in the case of pediatric Crohn’s Hospital, endoscopy is commonly used.
However, endoscopy has the disadvantage of being invasive compared to the advantage of providing accurate mucosal information. In particular, in the case of children, it is true that they are more exposed to this risk because of the thickness of the large intestine as well as the thin mucous membrane.
Similarly, MRI, which is used as an alternative, has limitations in that a contrast agent must be taken and sedation is required according to the age of the child.
It is for this reason that contrast-enhanced ultrasound has emerged as an alternative. This is because it is non-invasive, relatively inexpensive, and easily accessible.
In particular, in the case of contrast-enhanced ultrasound, it can be used to confirm the severity of the disease, treatment response, and complications in that it can visualize the intestinal wall and mesenteric perfusion in real time.
However, unlike adult Crohn’s disease, for which evidence is being accumulated, there is still insufficient evidence on whether contrast-enhanced ultrasound can be applied to children.
Comparison of contrast-enhanced ultrasound epidemiological and clinical parameters according to disease activity
This is the background of a research team led by Professor Park So-won of Yonsei University College of Medicine conducting a study on the effectiveness of contrast-enhanced ultrasound for children with Crohn’s disease in Korea.
Accordingly, the research team performed contrast-enhanced ultrasound on pediatric Crohn’s disease patients from August 2020 to August 2021 and compared and analyzed it with a control group.
As a result, children with activated Crohn’s disease had an erythrocyte sedimentation rate (ESR) of 13.0 mm/hr on contrast-enhanced ultrasound, which was significantly higher than that of patients without (2.0 mm/hr).
C-reactive protein (CRP) showed the same trend. Children with active Crohn’s disease recorded 4.7 mg/dL, whereas children with inactive Crohn’s disease recorded only 0.55 mg/dL.
This trend was evident as the slope (gradient) at the apex (peak) on the tonic-enhanced ultrasound. The active group had a slope of 1.18 and the inactive group had a slope of 0.93, showing a clear difference.
“This study is significant in that it is the first study to show that there is a difference in the average slope at the peak according to Crohn’s disease activity,” the researchers said. “This quantification parameter is the difference in the ratio between peak height and time to peak It shows that synergy using this is possible.”
“Eventually, this means that contrast-enhanced ultrasound is very safe and inexpensive for pediatric patients and has sufficient utility as a tool that can specifically diagnose whether or not Crohn’s disease is activated,” he said.
2023-07-10 20:30:00
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