Small Intestinal Contrast Ultrasonography (SICUS) in Crohn’s Disease: Systematic Review and Meta-Analysis
The diagnosis of Crohn’s Disease (CD) is based on a combination of clinical symptoms, laboratory tests, endoscopy, and imaging data. In Small Intestine Contrast Ultrasonography (SICUS), the ingestion of a macrogol solution as an oral contrast medium may optimize image quality. We performed a meta-an...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/24/7714 |
| _version_ | 1797380525438009344 |
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| author | Giuseppe Losurdo Margherita De Bellis Raffaella Rima Chiara Maria Palmisano Paola Dell’Aquila Andrea Iannone Enzo Ierardi Alfredo Di Leo Mariabeatrice Principi |
| author_facet | Giuseppe Losurdo Margherita De Bellis Raffaella Rima Chiara Maria Palmisano Paola Dell’Aquila Andrea Iannone Enzo Ierardi Alfredo Di Leo Mariabeatrice Principi |
| author_sort | Giuseppe Losurdo |
| collection | DOAJ |
| description | The diagnosis of Crohn’s Disease (CD) is based on a combination of clinical symptoms, laboratory tests, endoscopy, and imaging data. In Small Intestine Contrast Ultrasonography (SICUS), the ingestion of a macrogol solution as an oral contrast medium may optimize image quality. We performed a meta-analysis to evaluate the diagnostic performance of SICUS for CD. A literature search was performed in August 2023. We selected only studies where SICUS was compared to a technique that allows the assessment of the whole gastrointestinal tract, such as an MRE, a CT scan, or a surgical evaluation. We estimated pooled weighted sensitivity, specificity, and likelihood ratio for positive and negative tests (PLR/NLR) of SICUS. Summary receiver operating characteristic curves (SROC) were drawn, and pooled areas under the curve (AUC) were calculated. Five studies with 325 CD patients were included. SICUS showed a pooled sensitivity for the diagnosis of 95% (95% confidence interval CI 89–99%), a specificity = 77% (95% CI 60–90%), and the AUC was 0.94. SICUS demonstrated a pooled sensitivity for strictures of 78% (95% CI 63–88%) and a specificity = 96% (95% CI 85–99%), with AUC = 0.93. For abscesses, SICUS demonstrated a pooled sensitivity of 100% (95% CI 59–100%) and a specificity of 90% (95% CI 74–98%). Fistulae were detected with a pooled sensitivity of 77% (95% CI 46–95%) and a specificity of 92% (95% CI 75–99%). SICUS demonstrated excellent diagnostic performance compared to the gold standard despite some clinical scenarios (stenosis/fistulae) showing suboptimal diagnostic effectiveness. |
| first_indexed | 2024-03-08T20:38:32Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T20:38:32Z |
| publishDate | 2023-12-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-18d89b67a15e4db08105bb48a2cab53d2023-12-22T14:17:31ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-011224771410.3390/jcm12247714Small Intestinal Contrast Ultrasonography (SICUS) in Crohn’s Disease: Systematic Review and Meta-AnalysisGiuseppe Losurdo0Margherita De Bellis1Raffaella Rima2Chiara Maria Palmisano3Paola Dell’Aquila4Andrea Iannone5Enzo Ierardi6Alfredo Di Leo7Mariabeatrice Principi8Section of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, ItalySection of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, ItalySection of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, ItalyInternal Medicine Unit “C. Frugoni”, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, ItalySection of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, ItalySection of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, ItalySection of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, ItalySection of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, ItalySection of Gastroenterology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, 70124 Bari, ItalyThe diagnosis of Crohn’s Disease (CD) is based on a combination of clinical symptoms, laboratory tests, endoscopy, and imaging data. In Small Intestine Contrast Ultrasonography (SICUS), the ingestion of a macrogol solution as an oral contrast medium may optimize image quality. We performed a meta-analysis to evaluate the diagnostic performance of SICUS for CD. A literature search was performed in August 2023. We selected only studies where SICUS was compared to a technique that allows the assessment of the whole gastrointestinal tract, such as an MRE, a CT scan, or a surgical evaluation. We estimated pooled weighted sensitivity, specificity, and likelihood ratio for positive and negative tests (PLR/NLR) of SICUS. Summary receiver operating characteristic curves (SROC) were drawn, and pooled areas under the curve (AUC) were calculated. Five studies with 325 CD patients were included. SICUS showed a pooled sensitivity for the diagnosis of 95% (95% confidence interval CI 89–99%), a specificity = 77% (95% CI 60–90%), and the AUC was 0.94. SICUS demonstrated a pooled sensitivity for strictures of 78% (95% CI 63–88%) and a specificity = 96% (95% CI 85–99%), with AUC = 0.93. For abscesses, SICUS demonstrated a pooled sensitivity of 100% (95% CI 59–100%) and a specificity of 90% (95% CI 74–98%). Fistulae were detected with a pooled sensitivity of 77% (95% CI 46–95%) and a specificity of 92% (95% CI 75–99%). SICUS demonstrated excellent diagnostic performance compared to the gold standard despite some clinical scenarios (stenosis/fistulae) showing suboptimal diagnostic effectiveness.https://www.mdpi.com/2077-0383/12/24/7714Crohn’s diseasediagnosisultrasoundmagnetic resonance enterographyoral contrastSICUS |
| spellingShingle | Giuseppe Losurdo Margherita De Bellis Raffaella Rima Chiara Maria Palmisano Paola Dell’Aquila Andrea Iannone Enzo Ierardi Alfredo Di Leo Mariabeatrice Principi Small Intestinal Contrast Ultrasonography (SICUS) in Crohn’s Disease: Systematic Review and Meta-Analysis Journal of Clinical Medicine Crohn’s disease diagnosis ultrasound magnetic resonance enterography oral contrast SICUS |
| title | Small Intestinal Contrast Ultrasonography (SICUS) in Crohn’s Disease: Systematic Review and Meta-Analysis |
| title_full | Small Intestinal Contrast Ultrasonography (SICUS) in Crohn’s Disease: Systematic Review and Meta-Analysis |
| title_fullStr | Small Intestinal Contrast Ultrasonography (SICUS) in Crohn’s Disease: Systematic Review and Meta-Analysis |
| title_full_unstemmed | Small Intestinal Contrast Ultrasonography (SICUS) in Crohn’s Disease: Systematic Review and Meta-Analysis |
| title_short | Small Intestinal Contrast Ultrasonography (SICUS) in Crohn’s Disease: Systematic Review and Meta-Analysis |
| title_sort | small intestinal contrast ultrasonography sicus in crohn s disease systematic review and meta analysis |
| topic | Crohn’s disease diagnosis ultrasound magnetic resonance enterography oral contrast SICUS |
| url | https://www.mdpi.com/2077-0383/12/24/7714 |
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