Correlación entre la endoscopia y la ecografía intestinal para la evaluación de la recurrencia posquirúrgica de la enfermedad de Crohn

• Jorge Yebra Carmona ^[1] ; Joaquín Poza Cordón ^[1] ; Cristina Suárez Ferrer ^[1] ; Eduardo Martín Arranz ^[1] ; Javier Lucas Ramos ^[1] ; Irene Andaluz García ^[1] ; María Sánchez Azofra ^[1] ; José Luis Rueda García ^[1] ; María Dolores Martín Arranz ^[1]
  1. [1] Hospital Universitario La Paz

     Hospital Universitario La Paz

     Madrid, España

     
• Localización: Gastroenterología y hepatología, ISSN 0210-5705, Vol. 45, Nº. 1, 2022, págs. 40-46
• Idioma: español
• Títulos paralelos:
  • Correlation between endoscopy and intestinal ultrasound for the evaluation of postoperative recurrence of Crohn's disease
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• Resumen
  • español

    Objetivo La ecografía intestinal se considera una alternativa para la evaluación de la recurrencia posquirúrgica (RPQ) de la enfermedad de Crohn. El objetivo de este estudio es evaluar la correlación entre los hallazgos ecográficos y endoscópicos.

    Métodos Se recogieron de forma retrospectiva los datos de pacientes con enfermedad de Crohn y resección ileocecal en los que se había realizado una colonoscopia y una ecografía intestinal para la detección de RPQ. La RPQ se evaluó empleando el índice de Rutgeerts (IR). Los hallazgos ecográficos analizados fueron el grosor de la pared intestinal, la hiperemia parietal por Doppler, la desestructuración del patrón de capas y la proliferación fibrograsa.

    Resultados Se incluyó a un total de 31 pacientes, 15 (48,4%) sin recurrencia (IR?

    Conclusiones En nuestra experiencia, la ecografía tiene una alta rentabilidad diagnóstica para la detección de RPQ y puede considerarse en muchas ocasiones como una alternativa válida y no invasiva a la ileocolonoscopia.

  • English

    Objective Intestinal ultrasound is considered to be a valid alternative for the evaluation of post-operative recurrence (POR) of Crohn's disease. The aim of this study is to assess the correlation between ultrasound and endoscopic findings.

    Methods Patients with Crohn's disease were retrospectively recruited who had undergone ileocecal resection, and for whom a colonoscopy and intestinal ultrasound had been performed for the detection of POR. Recurrence was assessed using the Rutgeerts score (RS). The ultrasound findings analysed were bowel wall thickness (BWT), parietal hyperaemia using power Doppler, loss of layer pattern and mesenteric fat hypertrophy.

    Results A total of 31 patients were included, of which 15 (48.4%) had no POR (RS < 2b) and 16 (51.6%) had POR (RS ≥ 2b). A statistically significant association was identified between BWT and the presence of endoscopic recurrence (a mean of 2.75 mm vs. 5.68 mm, P>0.001). There was also a statistically significant difference in hyperaemia between the 2 groups (P=0.03). For wall thickness, an area under the ROC curve (AUC) of 92.9% was obtained, and with a cut-off point of 3.4 mm, a sensitivity of 100% and specificity of 86.6%. When comparing with the most frequent biomarkers (fecal calprotectin and serum CRP), a higher AUC was obtained for wall thickness (72.3% and 72.3% vs. 92.9%).

    Conclusions In our experience, ultrasound has high diagnostic efficacy in the detection of POR and can be considered a valid non-invasive alternative to endoscopy.