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The diagnosis of inflammatory bowel disease (IBD) can sometimes be challenging. By corroborating clinical, imaging and histological data, the two main entities of IBD, ulcerative colitis and Crohn's disease (CD), can be differentiated in most cases. However, there remains 10–20% of patients where the diagnosis cannot be accurately established, in which case the term "IBD unclassified" is used. The imaging techniques most used to evaluate patients with IBD include colonoscopy, ultrasonography and magnetic resonance imaging. Endoscopic ultrasonography is mainly recommended for the evaluation of perianal CD. Through this work, we aim to identify other uses of this method in the case of patients with IBD. [ABSTRACT FROM AUTHOR]

Crohn's disease represents an inflammatory bowel disease of unknown etiology, with chronic evolution, which may affect any segment of the digestive tract. The main classes of drugs used in patients with inflammatory bowel disease include: aminosalicylates, corticosteroids, immunosuppressants, biological agents and antibiotics. Biological therapy with anti-TNF-α agents offers significant therapeutic benefits, but their use requires caution, as they can also be associated with numerous side effects. We present the case of a female patient known with Crohn's disease, under going biological therapy with adalimumab, who develop [ABSTRACT FROM AUTHOR]

Imaging techniques like entero-RM and GIUS (gastrointestinal endoscopy) were developed as complementary methods to colonoscopy for a better and complete assessment of patients with Crohn's disease. GIUS has the advantage that it can be repeated whenever needed to monitor the evolution and response to treatment. Our aim is to evaluate the severity of intestinal damage in patients with ileal Crohn's disease using GIUS and MR-enterography. This study included 10 patients with ileal Crohn's disease with a mean age of 36 years. Patients were evaluated via GIUS + CEUS, using a Hitachi Arieta ultrasonography system with a 7.5 MHz linear transducer. The contrast agent used was SonoVue, 4,8 ml. The assessed parameters included: the thickness of the intestinal wall, parietal stratification, motility, the presence of lymph nodes and mesenteric fat, color Doppler parameters. Using a dedicated software CEUS parameters were assessed: Peak enhancement (PE), Wash-in area under the curve (WiAUC), Rise time (RT), Mean transit time (MTT), Wash-in rate (WiR), etc. The MR-enterography was performed using a Philips Ingenia 3T device, and for the quantification of severity we used the modified MaRIA index. The mean severity index (CDAI, respectively HBI-Harvey-Bradshaw Index) was 173.8 (STDEV 109.06) for CDAI and 6.8 (STDEV 4.18) for HBI. The parameters that were statistically correlated with the activity and severity of the disease assessed by CDAI and HBI are: thickening of the intestinal wall over 4 mm, the presence of Doppler signal at the level of intestinal wall (Limberg classification) and enhancement parameters on CEUS. On GIUS, the average thickness of the terminal ileum wall was 6.28 mm (STDEV 1.13). The average for the Limberg score was 2 (STDEV 0.94), and for the modified MaRIA score was 7.40 (STDEV 5.05). We found that there are correlations between GIUS parameters, entero-RM parameters and the severity of the disease. Intestinal ultrasound has been shown to be useful in assessing the severity of ileal Crohn's disease and response to treatment comparable to MR-enterography. Entero-RM seems to be superior to GIUS in detecting proximal stenosis of ileum. [ABSTRACT FROM AUTHOR]