Objectives—Transcutaneous bowel sonography is a nonionizing
imaging modality used in inflammatory bowel disease. Although available in
Europe, its uptake in North America has been limited. Since the accuracy of
bowel sonography is highly operator dependent, low-volume centers in North America may not achieve the same
diagnostic accuracy reported in the European literature. Our objective was to
determine the diagnostic accuracy of bowel sonography in a nonexpert low-volume
center.
Methods—All cases of bowel sonography at a single tertiary
care center during an 18-month period were reviewed. Bowel sonography was
compared with reference standards, including small-bowel follow-through,
computed tomography, magnetic resonance imaging, colonoscopy, and surgical
findings.
Results—A total of 103 cases were included for analysis
during the study period. The final diagnoses included Crohn disease (72),
ulcerative colitis (8), hemolytic uremic syndrome (1), and normal (22). The sensitivity
and specificity of bowel sonography for intestinal wall inflammation were 87.8%
and 92.6%, respectively. In the subset of patients who had complications of Crohn disease, the
sensitivity and specificity were 50% and 100% for fistulas and 14% and 100% for
strictures. One patient had an abscess, which was detected by bowel sonography.
Abnormal bowel sonographic findings contributed to the escalation of treatment
in 55% of cases.
Conclusions—Bowel sonography for inflammatory bowel disease
can be performed in low-volume centers and provides diagnostic accuracy for
luminal disease comparable with published data, although it is less sensitive
for complications of Crohn disease.
