RESUMEN

BACKGROUND: Non-invasive methods play an important role in clinical assessment of Crohn's disease. Recent studies have highlighted the effectiveness and reliability of intestinal ultrasonography. We aimed to examine the relationship between intestinal ultrasonography and the clinical, endoscopic, and computed tomography enterography findings, and to assess the activity of Crohn's disease. METHODS: This was a 1-year prospective study involving patients diagnosed with Crohn's Disease. Clinical and endoscopic activity indi- ces, and intestinal ultrasonography and computed tomography enterography findings were evaluated. Intestinal wall thickness, mes- enteric inflammation, lymphadenopathy, and complications were evaluated by intestinal ultrasonograpy and computed tomography enterography, while the superior mesenteric artery flow velocity, resistive index, and Limberg score were assessed by Doppler intestinal ultrasonography. RESULTS: Seventy-nine patients with Crohn's disease were included. A significant correlation was found between intestinal wall thick- ness, mesenteric inflammation, and complications in intestinal ultrasonography and computed tomography enterography (P = .0001). According to the receiver operating curve analysis, the intestinal wall thickness, and mesenteric inflammation were correlated with the Crohn's Disease Activity Index, Harvey-Bradshaw Index, and SES-CD scores (P < .05), and they were very effective in distinguishing active from inactive disease. According to the Crohn's Disease Activity Index and SES-CD scores, Doppler flow velocity of the superior mesenteric artery was significantly higher in the active group than in the inactive group (P < .05). The Limberg score was very consistent with the Crohn's Disease Activity Index, Harvey-Bradshaw Index , and the results of the Simple Endoscopic Score for Crohn's Disease (P < .0001). CONCLUSION: Our study showed that intestinal ultrasonography is an effective and reliable method for assessment of Crohn's disease activity compared to clinical, endoscopic, and CTE findings.

Asunto(s)

Enfermedad de Crohn , Enfermedad de Crohn/diagnóstico por imagen , Humanos , Inflamación , Estudios Prospectivos , Reproducibilidad de los Resultados , Tomografía Computarizada por Rayos X , Ultrasonografía

RESUMEN

A 58-year old patient with a history of subungual malign melanoma was referred to our department for a 18F-FDG positron emission tomography (PET)/computed tomography (CT) whole body scan. An unexpected 18F-FDG uptake in left ventricule which mimicked either trombus or physiological papillary muscle was detected. Filling defect of intravenous contrast in CT images was also demonstrated in left ventricule cavity. Magnetic resonance imaging scan confirmed cardiac mass with metastatic features of malign melanoma in left ventricule