Journal: Diagnostics

Article Title: Elastography as a Discriminator Between Fibrotic and Inflammatory Strictures in Crohn’s Disease: A Dead End or Bright Future in Clinical Decision-Making? Critical Review

doi: 10.3390/diagnostics14202299

Figure Lengend Snippet: Characteristics of the recent publications not included in the investigated review series. Abbreviations: ARFI—acoustic radiation force impulse; AUROC—area under the receiver operating curve; CD—Crohn’s disease; CEUS—contrast-enhanced ultrasound; CE-CT—contrast-enhanced computed tomography; CI—confidence interval; HR—hazard ratio; IUS—intestinal ultrasound MRE—magnetic resonance enterography; N/A—not applicable; P—prospective; R—retrospective; SBWT—small-bowel wall thickness; SWD—shear wave dispersion; SWE—shear wave elastography; SWV—shear wave velocity; UEI—ultrasound elasticity imaging; US—ultrasound.

Article Snippet: Abu-Ata (2023) [ ] , P , Transabdominal , 19 (18 with diagnostic UEI) , Pediatric , stricturing small bowel CD requiring surgery , SWE , SWV , B-mode , N/A , Histopathology, second harmonic imaging microscopy (SHIM) from surgical specimen , Siemens Acuson S3000 , To determine the relationship between intestinal wall stiffness on US (SWE) vs. fibrosis and smooth muscle hypertrophy (histology, second harmonic imaging microscopy) in stricturing pediatric CD. , There was no significant correlations between histological bowel wall fibrosis and any measure of bowel wall or overall right lower quadrant stiffness (all p -values > 0.05) . There were multiple significant positive correlations between histological muscularis mucosa inner layer smooth muscle hypertrophy scores and multiple SWE metrics, including bowel wall stiffness with 10% abdominal strain (r = 0.72, p = 0.002) and overall right lower quadrant stiffness with 20% abdominal strain (r = 0.71, p = 0.002) a significant negative correlation between entire bowel wall active inflammation and overall right lower quadrant stiffness with 20% abdominal strain (r = −0.60, p = 0.009). There was a significant positive correlation between entire bowel wall smooth muscle hypertrophy and bowel wall stiffness with 20% abdominal strain (r = 0.47, p = 0.047). The ratio of entire bowel wall histological smooth muscle hypertrophy-to-inflammation was positively correlated with overall right lower quadrant stiffness with 20% abdominal strain (r = 0.67, p = 0.002). There were significant negative correlations between histological mucosal active inflammation scores and multiple SWE metrics, including bowel wall stiffness with 10% abdominal strain (r = −0.50, p = 0.04) and overall right lower quadrant stiffness with 20% abdominal strain (r = −0.69, p = 0.0015)..

Techniques: Computed Tomography, Dispersion, Imaging, Diagnostic Assay, Histopathology, Microscopy, Biomarker Discovery