1.Intestinal ultrasound for intestinal Behçet disease reflects endoscopic activity and histopathological findings
Katsuki YAGUCHI ; Reiko KUNISAKI ; Sho SATO ; Kaori HIRAI ; Misato IZUMI ; Yoshimi FUKUNO ; Mami TANAKA ; Mai OKAZAKI ; Rongrong WU ; Yurika NISHIKAWA ; Yusuke MATSUNE ; Shunsuke SHIBUI ; Yoshinori NAKAMORI ; Masafumi NISHIO ; Mao MATSUBAYASHI ; Tsuyoshi OGASHIWA ; Ayako FUJII ; Kenichiro TORITANI ; Hideaki KIMURA ; Eita KUMAGAI ; Yukiko SASAHARA ; Yoshiaki INAYAMA ; Satoshi FUJII ; Toshiaki EBINA ; Kazushi NUMATA ; Shin MAEDA
Intestinal Research 2024;22(3):297-309
Background/Aims:
Intestinal Behçet disease is typically associated with ileocecal punched-out ulcers and significant morbidity and mortality. Intestinal ultrasound is a noninvasive imaging technique for disease monitoring. However, no previous reports have compared intestinal ultrasound with endoscopic ulcer activity or histopathological findings for intestinal Behçet disease. We evaluated the usefulness of intestinal ultrasound for assessing the activity of ileocecal ulcers in intestinal Behçet disease.
Methods:
We retrospectively compared intestinal ultrasound findings with 73 corresponding endoscopic images and 6 resected specimens. The intestinal ultrasound findings were assessed for 7 parameters (bowel wall thickness, vascularity [evaluated using the modified Limberg score with color Doppler], bowel wall stratification, white-plaque sign [strong hyperechogenic lines or spots], mesenteric lymphadenopathy, extramural phlegmons, and fistulas), and endoscopic ulcer activity was classified into active, healing, and scar stages. Histopathological findings were evaluated by consensus among experienced pathologists.
Results:
Bowel wall thickness (P< 0.001), vascularity (P< 0.001), loss of bowel wall stratification (P= 0.015), and white-plague sign (P= 0.013) were significantly exacerbated in the endoscopic active ulcer stage. Receiver operating characteristic curve analysis revealed that a bowel wall thickness of > 5.5 mm (sensitivity 89.7%, specificity 85.3%) was potentially useful for detecting active lesions. When compared with histopathological findings, an increase in bowel wall thickness reflected the ulcer marginal ridge, and the white-plaque sign reflected the ulcer bottom.
Conclusions
Intestinal ultrasound is useful for monitoring intestinal ulcer activity in intestinal Behçet disease.
2.The AFSUMB Consensus Statements and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound using Sonazoid
Jae Young LEE ; Yasunori MINAMI ; Byung Ihn CHOI ; Won Jae LEE ; Yi-Hong CHOU ; Woo Kyoung JEONG ; Mi-Suk PARK ; Nobuki KUDO ; Min Woo LEE ; Ken KAMATA ; Hiroko IIJIMA ; So Yeon KIM ; Kazushi NUMATA ; Katsutoshi SUGIMOTO ; Hitoshi MARUYAMA ; Yasukiyo SUMINO ; Chikara OGAWA ; Masayuki KITANO ; Ijin JOO ; Junichi ARITA ; Ja-Der LIANG ; Hsi-Ming LIN ; Christian NOLSOE ; Odd Helge GILJA ; Masatoshi KUDO
Ultrasonography 2020;39(3):191-220
The first edition of the guidelines for the use of ultrasound contrast agents was published in 2004, dealing with liver applications. The second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some nonliver applications. The third edition of the contrast-enhanced ultrasound (CEUS) guidelines was the joint World Federation for Ultrasound in Medicine and Biology-European Federation of Societies for Ultrasound in Medicine and Biology (WFUMB-EFSUMB) venture in conjunction with other regional US societies such as Asian Federation of Societies for Ultrasound in Medicine and Biology, resulting in a simultaneous duplicate on liver CEUS in the official journals of both WFUMB and EFSUMB in 2013. However, no guidelines were described mainly for Sonazoid due to limited clinical experience only in Japan and Korea. The new proposed consensus statements and recommendations provide general advice on the use of Sonazoid and are intended to create standard protocols for the use and administration of Sonazoid in hepatic and pancreatobiliary applications in Asian patients and to improve patient management.