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The postoperative course of Crohn’s disease (CD) is best predicted by ileocolonoscopy. Ultrasonography (US) has been proposed as indicator for postsurgical recurrence, but further confirmation is needed. Dr Antonio Rispo and colleagues performed a systemic review with meta-analysis to assess the pooled diagnostic accuracy of US in the evaluation of postsurgical recurrence. The systematic review was performed in PubMed/MEDLINE, EMBASE, SCOPUS, and Cochrane databases to identify studies assessing the US accuracy in postsurgical recurrence diagnosis.
| | Pooled sensitivity of US in detecting postsurgical recurrence was 0.94 | | Inflammatory Bowel Diseases |
A sub-analysis between bowel sonography (BS), small-intestine contrast ultrasound (SICUS), and contrast-enhanced ultrasound (CEUS) was performed. Pooling was performed using diagnostic fixed or random-effect model according with heterogeneity. The research team identified 10 studies that met the inclusion criteria. Pooled sensitivity and specificity of US in detecting postsurgical recurrence were 0.94 and 0.84, respectively. At sub-analysis, the team found that pooled sensitivity and specificity were 0.82 and 0.88 respectively for BS, with 0.99 and 0.74 for SICUS. The researchers reported that an SROC curve was built to establish the best bowel wall thickness (BWT) cutoff able to predict the presence of severe postsurgical recurrence (Rutgeerts ≥3): a BWT ≥5.5 mm at US revealed sensitivity of 84%, specificity of 98%. Dr Rispo's team concludes, "US shows high sensitivity and specificity for the diagnosis of postsurgical recurrence." "SICUS appears more sensitive—but less specific—than BS, while the role of CEUS needs further investigation." "A cutoff value of BWT ≥5.5 mm is strongly indicative of severe postsurgical recurrence."
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