Year 2021 / Volume 113 / Number 7
Original
Prognostic value of ultrasound activity and parietal healing in patients with Crohn’s disease

494-499

DOI: 10.17235/reed.2020.7347/2020

Cristina Suárez Ferrer, Joaquín Poza Cordón, Olivia Crivillén Anguita, Patricia Mayor Delgado, José Luis Rueda García, Eduardo Martín Arranz, María Sánchez Azofra, Jesús Noci Belda, Laura García Ramírez, María Dolores Martín Arranz,

Abstract
Introduction: the “treat to target” strategy for the management of patients with Crohn’s disease (CD) requires simple, reliable and non-invasive tools for continuous monitoring of the disease. Intestinal ultrasound has been proposed as an emerging technique that could be very useful in this field. Material and methods: patients who had undergone an intestinal ultrasound in the clinical practice between February 2013 and October 2018 at our hospital were retrospectively included. The evolution of the patients during follow-up was assessed based on the presence of ultrasound activity and the therapeutic changes based on the results. Results: two hundred and seventy-seven CD patients were included and the median follow-up time was 24 months (range 5-73 months). Signs of ultrasound inflammatory activity were identified in 166 patients (60 %), and of them, treatment was escalated in 116 patients (70 %) based on the results of the ultrasound. Among patients with identified ultrasound activity, in 166 patients (60 %) the evolution was less favorable than in those without activity, with a shorter time until the next outbreak. Thus, the median disease-free survival (without outbreaks) after performing the ultrasound was 18 months when ultrasound activity was identified (although in most of the patients [70 %] the treatment had been escalated) vs 47 months in patients without ultrasound activity. However, these differences were not statistically significant (p < 0.0001). Among the 111 patients without ultrasound activity, those who achieved “parietal healing” (74 patients) had a better evolution with a 12 % subsequent outbreak vs 27 % during follow-up (p = 0.05). Thus, 15 % of patients with parietal healing had an outbreak vs 34 % of those who had not normalized the ultrasound findings after three years of follow-up. Conclusion: intestinal ultrasound is a technique capable of detecting inflammatory activity in patients with Crohn’s disease and the presence of ultrasound activity is a risk factor for a new outbreak of activity and/or clinical relapse. Likewise, the presence of “parietal or transmural healing” (PH) is associated with a better evolution of patients during follow-up. Thus, it could be a more precise objective to consider deep remission in CD, with intestinal ultrasound being a useful technique for this purpose.
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Suárez Ferrer C, Poza Cordón J, Crivillén Anguita O, Mayor Delgado P, Rueda García J, Martín Arranz E, et all. Prognostic value of ultrasound activity and parietal healing in patients with Crohn’s disease. 7347/2020


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Publication history

Received: 16/06/2020

Accepted: 17/09/2020

Online First: 02/12/2020

Published: 07/07/2021

Article revision time: 90 days

Article Online First time: 169 days

Article editing time: 386 days


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