Multimodality ultrasound in Crohn’s disease strictures

Table 1 Diagnostic accuracy of small intestine contrast ultrasonography for detecting Crohn’s disease strictures across key validation studies

Ref.	Design	Number	Reference standard	Sensitivity (%)	Specificity (%)	Definition (if stated)	Comparator modality (if any)	Kappa (if any)	Comments/additional findings
Calabrese et al[7], 2013	Prospective comparative study	38	Surgical and histopathological findings	95.5	80	Lumen < 1 cm or upstream dilation > 2.5 cm with wall thickening	CT-enteroclysis	Not reported	High correlation with surgical lesion extent (ρ = 0.83)
Onali et al[8], 2012	Prospective validation	13	Surgical and histological findings	92	Not separately stated	Wall thickening + lumen narrowing ± prestenotic dilation	CT-enteroclysis	Not reported	Feasible in all patients; comparable to CTE for all complications
Parente et al[4], 2004	Prospective cohort	102	Barium enteroclysis, ileocolonoscopy	89	93	Stiff wall, lumen narrowing + upstream dilation	Conventional US, BE	0.95 (for expert vs reference)	PEG-enhanced US improved sensitivity, reduced interobserver variability
Calabrese et al[14], 2009	Prospective postoperative study	72	Ileocolonoscopy (Rutgeerts’ score)	92.5	20	BWT > 3 mm, lumen < 1 cm ± dilation > 2.5 cm	None	Not stated	BWT correlated with endoscopic recurrence (r = 0.67)
Calabrese et al[5], 2005	Prospective comparative study	38	Surgical/histological findings	95	80	Wall thickening, lumen < 1 cm, ± dilation > 2.5 cm	CT-enteroclysis	Not reported	High correlation with extent of disease (ρ = 0.83)
Pallotta et al[13], 2012	Prospective study vs surgical findings	49	Surgical/pathology	97.5	100	Lumen < 1 cm, wall thickening, ± dilation > 2.5 cm	IUS	0.93	Also reported fistula (96%) and abscess (100%) accuracy
Kumar et al[10], 2014	Retrospective comparative study	25	Intraoperative findings	88	88	Wall thickening + fixed loop or absence of peristalsis	MRE	0.73	Substantial agreement with MRE and surgery
Chatu et al[6], 2012	Retrospective	52	Multimodal including surgery	88	Not stated	Wall thickening + narrowed lumen	CT/MRE	Not reported	SICUS helped define disease extent and complications
Aloi et al[11], 2015	Pediatric prospective cohort	26	MRE	85.7	100	Not precisely defined	MRE	0.82	High agreement between modalities

CD: Crohn’s disease; SICUS: Small intestine contrast ultrasonography; CT: Computed tomographic; CTE: Computed tomographic enteroclysis; MRE: Magnetic resonance enterography; BE: Barium enteroclysis; BWT: Bowel wall thickness; IUS: Intestinal ultrasound.