A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn's perianal fistulas
Background & Aims: To determine accuracy of endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) for evaluation of Crohn's disease perianal fistulas. Methods: Thirty-four patients with suspected Crohn's disease perianal fistulas were prospectively enrolled in a blinded stud...
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| Veröffentlicht in: | Gastroenterology (New York, N.Y. 1943) N.Y. 1943), 2001-11, Vol.121 (5), p.1064-1072 |
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| creator | Schwartz, David A. Wiersema, Maurits J. Dudiak, Kika M. Fletcher, J.G. Clain, Jonathan E. Tremaine, William J. Zinsmeister, Alan R. Norton, Ian D. Boardman, Lisa A. Devine, Richard M. Wolff, Bruce G. Young-Fadok, Tonia M. Diehl, Nancy N. Pemberton, John H. Sandborn, William J. |
| description | Background & Aims: To determine accuracy of endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) for evaluation of Crohn's disease perianal fistulas. Methods: Thirty-four patients with suspected Crohn's disease perianal fistulas were prospectively enrolled in a blinded study comparing EUS, MRI, and examination under anesthesia (EUA). Fistulas were classified according to Parks' criteria, and a consensus gold standard was determined for each patient. Acceptable accuracy was defined as agreement with the consensus gold standard for ≥85% of patients. Results: Three patients did not undergo MRI; 1 did not undergo EUS or EUA; and consensus could not be reached for 1. Thirty-two patients had 39 fistulas (20 trans-sphincteric, 5 extra-sphincteric, 6 recto-vaginal, 8 others) and 13 abscesses. The accuracy of all 3 modalities was ≥85%: EUS 29 of 32 (91%, confidence interval [CI] 75%-98%), MRI 26 of 30 (87%, CI 69%-96%), and EUA 29 of 32 (91%, CI 75%-98%). Accuracy was 100% when any 2 tests were combined. Conclusions: EUS, MRI, and EUA are accurate tests for determining fistula anatomy in patients with perianal Crohn's disease. The optimal approach may be combining any 2 of the 3 methods.
GASTROENTEROLOGY 2001;121:1064-1072 |
| doi_str_mv | 10.1053/gast.2001.28676 |
| format | Article |
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GASTROENTEROLOGY 2001;121:1064-1072</description><identifier>ISSN: 0016-5085</identifier><identifier>EISSN: 1528-0012</identifier><identifier>DOI: 10.1053/gast.2001.28676</identifier><identifier>PMID: 11677197</identifier><identifier>CODEN: GASTAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Anesthesia ; Biological and medical sciences ; Crohn Disease - diagnosis ; Crohn Disease - surgery ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Pelvis - pathology ; Prospective Studies ; Rectal Fistula - diagnosis ; Rectal Fistula - surgery ; Rectum - diagnostic imaging ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Ultrasonography</subject><ispartof>Gastroenterology (New York, N.Y. 1943), 2001-11, Vol.121 (5), p.1064-1072</ispartof><rights>2001 American Gastroenterological Association</rights><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c480t-911cadc3a091d4276d27247c9db3e6acd3ac1f41431f9deea31ee2b38d4e9c2a3</citedby><cites>FETCH-LOGICAL-c480t-911cadc3a091d4276d27247c9db3e6acd3ac1f41431f9deea31ee2b38d4e9c2a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0016508501362248$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14099648$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11677197$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schwartz, David A.</creatorcontrib><creatorcontrib>Wiersema, Maurits J.</creatorcontrib><creatorcontrib>Dudiak, Kika M.</creatorcontrib><creatorcontrib>Fletcher, J.G.</creatorcontrib><creatorcontrib>Clain, Jonathan E.</creatorcontrib><creatorcontrib>Tremaine, William J.</creatorcontrib><creatorcontrib>Zinsmeister, Alan R.</creatorcontrib><creatorcontrib>Norton, Ian D.</creatorcontrib><creatorcontrib>Boardman, Lisa A.</creatorcontrib><creatorcontrib>Devine, Richard M.</creatorcontrib><creatorcontrib>Wolff, Bruce G.</creatorcontrib><creatorcontrib>Young-Fadok, Tonia M.</creatorcontrib><creatorcontrib>Diehl, Nancy N.</creatorcontrib><creatorcontrib>Pemberton, John H.</creatorcontrib><creatorcontrib>Sandborn, William J.</creatorcontrib><title>A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn's perianal fistulas</title><title>Gastroenterology (New York, N.Y. 1943)</title><addtitle>Gastroenterology</addtitle><description>Background & Aims: To determine accuracy of endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) for evaluation of Crohn's disease perianal fistulas. Methods: Thirty-four patients with suspected Crohn's disease perianal fistulas were prospectively enrolled in a blinded study comparing EUS, MRI, and examination under anesthesia (EUA). Fistulas were classified according to Parks' criteria, and a consensus gold standard was determined for each patient. Acceptable accuracy was defined as agreement with the consensus gold standard for ≥85% of patients. Results: Three patients did not undergo MRI; 1 did not undergo EUS or EUA; and consensus could not be reached for 1. Thirty-two patients had 39 fistulas (20 trans-sphincteric, 5 extra-sphincteric, 6 recto-vaginal, 8 others) and 13 abscesses. The accuracy of all 3 modalities was ≥85%: EUS 29 of 32 (91%, confidence interval [CI] 75%-98%), MRI 26 of 30 (87%, CI 69%-96%), and EUA 29 of 32 (91%, CI 75%-98%). Accuracy was 100% when any 2 tests were combined. Conclusions: EUS, MRI, and EUA are accurate tests for determining fistula anatomy in patients with perianal Crohn's disease. The optimal approach may be combining any 2 of the 3 methods.
GASTROENTEROLOGY 2001;121:1064-1072</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia</subject><subject>Biological and medical sciences</subject><subject>Crohn Disease - diagnosis</subject><subject>Crohn Disease - surgery</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Pelvis - pathology</subject><subject>Prospective Studies</subject><subject>Rectal Fistula - diagnosis</subject><subject>Rectal Fistula - surgery</subject><subject>Rectum - diagnostic imaging</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Ultrasonography</subject><issn>0016-5085</issn><issn>1528-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kD1vFDEQhi0EIkegpkNuIE324o_9chmdCCBFooHamrNnL0a79uLZjeAf8LPxcSelohr51eNXMw9jb6XYStHomwPQslVCyK3q2659xjayUX1VAvWcbcpoq0b0zQV7RfRDCGF0L1-yCynbrpOm27A_t9ylaYYcKEWeBo7RJ3JpDo6v45KB0hr9NZ_gEHEpYcYCQnTIQ8lCPFxziJ7jL5h4ITGXJ9LygBSADylzfIRxhSWc6nc5PcQr4jPmABFGPgRa1hHoNXsxwEj45jwv2fe7j992n6v7r5--7G7vK1f3YqmMlA680yCM9LXqWq86VXfO-L3GFpzX4ORQy1rLwXhE0BJR7XXvazROgb5kH069c04_17KpnQI5HMeydlrJdkqppmmbAt6cQJcTUcbBzrmcnH9bKexRvj3Kt0f59p_88uPduXrdT-if-LPtArw_A0AOxiEXj4GeuFoY09Z94cyJwyLiMWC25AIW5z5kdIv1Kfx3ib87XaQP</recordid><startdate>20011101</startdate><enddate>20011101</enddate><creator>Schwartz, David A.</creator><creator>Wiersema, Maurits J.</creator><creator>Dudiak, Kika M.</creator><creator>Fletcher, J.G.</creator><creator>Clain, Jonathan E.</creator><creator>Tremaine, William J.</creator><creator>Zinsmeister, Alan R.</creator><creator>Norton, Ian D.</creator><creator>Boardman, Lisa A.</creator><creator>Devine, Richard M.</creator><creator>Wolff, Bruce G.</creator><creator>Young-Fadok, Tonia M.</creator><creator>Diehl, Nancy N.</creator><creator>Pemberton, John H.</creator><creator>Sandborn, William J.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20011101</creationdate><title>A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn's perianal fistulas</title><author>Schwartz, David A. ; Wiersema, Maurits J. ; Dudiak, Kika M. ; Fletcher, J.G. ; Clain, Jonathan E. ; Tremaine, William J. ; Zinsmeister, Alan R. ; Norton, Ian D. ; Boardman, Lisa A. ; Devine, Richard M. ; Wolff, Bruce G. ; Young-Fadok, Tonia M. ; Diehl, Nancy N. ; Pemberton, John H. ; Sandborn, William J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c480t-911cadc3a091d4276d27247c9db3e6acd3ac1f41431f9deea31ee2b38d4e9c2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia</topic><topic>Biological and medical sciences</topic><topic>Crohn Disease - diagnosis</topic><topic>Crohn Disease - surgery</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Pelvis - pathology</topic><topic>Prospective Studies</topic><topic>Rectal Fistula - diagnosis</topic><topic>Rectal Fistula - surgery</topic><topic>Rectum - diagnostic imaging</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schwartz, David A.</creatorcontrib><creatorcontrib>Wiersema, Maurits J.</creatorcontrib><creatorcontrib>Dudiak, Kika M.</creatorcontrib><creatorcontrib>Fletcher, J.G.</creatorcontrib><creatorcontrib>Clain, Jonathan E.</creatorcontrib><creatorcontrib>Tremaine, William J.</creatorcontrib><creatorcontrib>Zinsmeister, Alan R.</creatorcontrib><creatorcontrib>Norton, Ian D.</creatorcontrib><creatorcontrib>Boardman, Lisa A.</creatorcontrib><creatorcontrib>Devine, Richard M.</creatorcontrib><creatorcontrib>Wolff, Bruce G.</creatorcontrib><creatorcontrib>Young-Fadok, Tonia M.</creatorcontrib><creatorcontrib>Diehl, Nancy N.</creatorcontrib><creatorcontrib>Pemberton, John H.</creatorcontrib><creatorcontrib>Sandborn, William J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schwartz, David A.</au><au>Wiersema, Maurits J.</au><au>Dudiak, Kika M.</au><au>Fletcher, J.G.</au><au>Clain, Jonathan E.</au><au>Tremaine, William J.</au><au>Zinsmeister, Alan R.</au><au>Norton, Ian D.</au><au>Boardman, Lisa A.</au><au>Devine, Richard M.</au><au>Wolff, Bruce G.</au><au>Young-Fadok, Tonia M.</au><au>Diehl, Nancy N.</au><au>Pemberton, John H.</au><au>Sandborn, William J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn's perianal fistulas</atitle><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle><addtitle>Gastroenterology</addtitle><date>2001-11-01</date><risdate>2001</risdate><volume>121</volume><issue>5</issue><spage>1064</spage><epage>1072</epage><pages>1064-1072</pages><issn>0016-5085</issn><eissn>1528-0012</eissn><coden>GASTAB</coden><abstract>Background & Aims: To determine accuracy of endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) for evaluation of Crohn's disease perianal fistulas. Methods: Thirty-four patients with suspected Crohn's disease perianal fistulas were prospectively enrolled in a blinded study comparing EUS, MRI, and examination under anesthesia (EUA). Fistulas were classified according to Parks' criteria, and a consensus gold standard was determined for each patient. Acceptable accuracy was defined as agreement with the consensus gold standard for ≥85% of patients. Results: Three patients did not undergo MRI; 1 did not undergo EUS or EUA; and consensus could not be reached for 1. Thirty-two patients had 39 fistulas (20 trans-sphincteric, 5 extra-sphincteric, 6 recto-vaginal, 8 others) and 13 abscesses. The accuracy of all 3 modalities was ≥85%: EUS 29 of 32 (91%, confidence interval [CI] 75%-98%), MRI 26 of 30 (87%, CI 69%-96%), and EUA 29 of 32 (91%, CI 75%-98%). Accuracy was 100% when any 2 tests were combined. Conclusions: EUS, MRI, and EUA are accurate tests for determining fistula anatomy in patients with perianal Crohn's disease. The optimal approach may be combining any 2 of the 3 methods.
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| ispartof | Gastroenterology (New York, N.Y. 1943), 2001-11, Vol.121 (5), p.1064-1072 |
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| subjects | Adolescent Adult Aged Anesthesia Biological and medical sciences Crohn Disease - diagnosis Crohn Disease - surgery Female Gastroenterology. Liver. Pancreas. Abdomen Humans Magnetic Resonance Imaging Male Medical sciences Middle Aged Other diseases. Semiology Pelvis - pathology Prospective Studies Rectal Fistula - diagnosis Rectal Fistula - surgery Rectum - diagnostic imaging Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Ultrasonography |
| title | A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn's perianal fistulas |
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