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Small intestinal contrast ultrasonography-based scoring system: a promising approach for the diagnosis and follow-up of celiac disease.
J Clin Gastroenterol 2005; 39(7):591-5JC

Abstract

BACKGROUND

Small intestinal ultrasonography with anechoic contrast agents (SICUS) has been shown to have a diagnostic accuracy on small bowel morphology similar to X-ray barium follow-through. Although extremely investigated by transabdominal ultrasonography, celiac disease, a common disorder of the small bowel, has been never studied by SICUS.

AIM

To asses SICUS characteristics of celiac disease patients.

PATIENTS AND METHODS

SICUS was performed using PEG 4000 as contrast agent. Twenty-three patients with celiac disease at the first diagnosis were enrolled and 30 healthy volunteers, matched for sex and age, were selected as control group. Celiac disease diagnosis was based on anti-gluten, anti-endomysium, and anti-transglutaminase positivity as well as jejunal histology. The following seven echographic parameters were considered: liquid endoluminal content before contrast, loop diameter, Kerckring's folds, peristaltic waves, ileal jejunalization, mesenteric lymphoadenomegaly, and Doppler resistance index (RI) of mesenteric superior artery. Statistical analysis was performed by Student's t test for unpaired data; one-way analysis of variance was used to correlate echographic and histologic pictures.

RESULTS

Loop diameter, Kerckring's fold number, peristaltic waves, and Doppler RI appeared to be significantly different between celiac disease patients and controls. Additionally, liquid content, ileal jejunalization, and mesenteric lymphoadenomegaly were present only in the celiacs (52.1%, 47.7%, and 95.6%, respectively), but not in controls. Only Doppler RI values significantly correlated with the histologic degree of damage.

CONCLUSIONS

SICUS could be a reliable and noninvasive technique to confirm a diagnosis of celiac disease performed using conventional investigations. The possibility of investigating the whole small bowel and the safety of repeating examinations could be useful in the follow-up of celiac patients.

Authors+Show Affiliations

"Umberto I" Hospital, Altamura, Bari, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16000926

Citation

Dell'Aquila, Paola, et al. "Small Intestinal Contrast Ultrasonography-based Scoring System: a Promising Approach for the Diagnosis and Follow-up of Celiac Disease." Journal of Clinical Gastroenterology, vol. 39, no. 7, 2005, pp. 591-5.
Dell'Aquila P, Pietrini L, Barone M, et al. Small intestinal contrast ultrasonography-based scoring system: a promising approach for the diagnosis and follow-up of celiac disease. J Clin Gastroenterol. 2005;39(7):591-5.
Dell'Aquila, P., Pietrini, L., Barone, M., Cela, E. M., Valle, N. D., Amoruso, A., ... Ierardi, E. (2005). Small intestinal contrast ultrasonography-based scoring system: a promising approach for the diagnosis and follow-up of celiac disease. Journal of Clinical Gastroenterology, 39(7), pp. 591-5.
Dell'Aquila P, et al. Small Intestinal Contrast Ultrasonography-based Scoring System: a Promising Approach for the Diagnosis and Follow-up of Celiac Disease. J Clin Gastroenterol. 2005;39(7):591-5. PubMed PMID: 16000926.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Small intestinal contrast ultrasonography-based scoring system: a promising approach for the diagnosis and follow-up of celiac disease. AU - Dell'Aquila,Paola, AU - Pietrini,Lorena, AU - Barone,Michele, AU - Cela,Ester M, AU - Valle,Nicola Della, AU - Amoruso,Anacinzia, AU - Minenna,Maria F, AU - Penna,Antonio, AU - De Francesco,Vincenzo, AU - Panella,Carmine, AU - Ierardi,Enzo, PY - 2005/7/8/pubmed PY - 2005/11/16/medline PY - 2005/7/8/entrez SP - 591 EP - 5 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 39 IS - 7 N2 - BACKGROUND: Small intestinal ultrasonography with anechoic contrast agents (SICUS) has been shown to have a diagnostic accuracy on small bowel morphology similar to X-ray barium follow-through. Although extremely investigated by transabdominal ultrasonography, celiac disease, a common disorder of the small bowel, has been never studied by SICUS. AIM: To asses SICUS characteristics of celiac disease patients. PATIENTS AND METHODS: SICUS was performed using PEG 4000 as contrast agent. Twenty-three patients with celiac disease at the first diagnosis were enrolled and 30 healthy volunteers, matched for sex and age, were selected as control group. Celiac disease diagnosis was based on anti-gluten, anti-endomysium, and anti-transglutaminase positivity as well as jejunal histology. The following seven echographic parameters were considered: liquid endoluminal content before contrast, loop diameter, Kerckring's folds, peristaltic waves, ileal jejunalization, mesenteric lymphoadenomegaly, and Doppler resistance index (RI) of mesenteric superior artery. Statistical analysis was performed by Student's t test for unpaired data; one-way analysis of variance was used to correlate echographic and histologic pictures. RESULTS: Loop diameter, Kerckring's fold number, peristaltic waves, and Doppler RI appeared to be significantly different between celiac disease patients and controls. Additionally, liquid content, ileal jejunalization, and mesenteric lymphoadenomegaly were present only in the celiacs (52.1%, 47.7%, and 95.6%, respectively), but not in controls. Only Doppler RI values significantly correlated with the histologic degree of damage. CONCLUSIONS: SICUS could be a reliable and noninvasive technique to confirm a diagnosis of celiac disease performed using conventional investigations. The possibility of investigating the whole small bowel and the safety of repeating examinations could be useful in the follow-up of celiac patients. SN - 0192-0790 UR - https://www.unboundmedicine.com/medline/citation/16000926/Small_intestinal_contrast_ultrasonography_based_scoring_system:_a_promising_approach_for_the_diagnosis_and_follow_up_of_celiac_disease_ L2 - http://Insights.ovid.com/pubmed?pmid=16000926 DB - PRIME DP - Unbound Medicine ER -