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Hassan MG, Alotaibi AM, Altuwaym RH, Alnuwaysir RH, Alharbi RB, Alnajashi LM, Alsaber MK, Aldakan HF, Hawesa HM, Abdelgabar ZA, Aldahes AS, Yaqob MG. Impact of Breathing Control Training Program on sonographic quantification of abdominal vasculature. Saudi Med J 2024; 45:525-530. [PMID: 38734441 PMCID: PMC11147564 DOI: 10.15537/smj.2024.45.5.20240083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVES To compare vascular scanning parameters (vessel diameter, peak systolic velocity, end-diastolic velocity, and resistive index) and scanning time before and after breathing control training program for selected abdominal vessels. METHODS This study was pre and post quasi-experimental. The researchers designed a breathing training program that gives participants instructions through a video describing breathing maneuvers. Data were collected at the ultrasound laboratory/College of Health and Rehabilitation Sciences in Princess Nourah bint Abdul Rahman University, Riyadh, Saudi Arabia from January 2023 to November 2023. About 49 volunteers at the university participated in the study. Scanning was performed two times for the right renal artery, upper abdominal aorta, inferior vena cava, and superior mesenteric artery. Scanning time was measured before and after the program as well. A paired sample t-test was used to compare the parameters means and time before and after the program. RESULTS The program had a significant effect on the following parameters: right renal artery peak systolic velocity (p=0.042), upper abdominal aortic peak systolic velocity, and resistive index (p=0.014, p=0.014 respectively), superior mesenteric artery and inferior vena cava diameters (p=0.010 and p=0.020). The scanning time was reduced significantly (p<0.001). CONCLUSION The breathing training program saves time and improves ultrasound measurement quality. Hospitals and health centers should consider the importance of breathing control training programs before abdominal scanning.
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Affiliation(s)
- Mahasin G. Hassan
- From the Department of Radiological Sciences (Hassan, Alotaibi, Altuwaym, Alnuwaysir, Alharbi, Alnajashi, Alsaber, Aldakan, Hawesa, Aldahes), College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University; from Software Development Department (Yaqob), N24 Company Limited, Riyadh; and from the Department of Radiological Sciences (Abdelgabar), Al-Ghad International Colleges for Applied Sciences, Madina, Kingdom of Saudi Arabia.
| | - Afnan M. Alotaibi
- From the Department of Radiological Sciences (Hassan, Alotaibi, Altuwaym, Alnuwaysir, Alharbi, Alnajashi, Alsaber, Aldakan, Hawesa, Aldahes), College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University; from Software Development Department (Yaqob), N24 Company Limited, Riyadh; and from the Department of Radiological Sciences (Abdelgabar), Al-Ghad International Colleges for Applied Sciences, Madina, Kingdom of Saudi Arabia.
| | - Raghad H. Altuwaym
- From the Department of Radiological Sciences (Hassan, Alotaibi, Altuwaym, Alnuwaysir, Alharbi, Alnajashi, Alsaber, Aldakan, Hawesa, Aldahes), College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University; from Software Development Department (Yaqob), N24 Company Limited, Riyadh; and from the Department of Radiological Sciences (Abdelgabar), Al-Ghad International Colleges for Applied Sciences, Madina, Kingdom of Saudi Arabia.
| | - Reem H. Alnuwaysir
- From the Department of Radiological Sciences (Hassan, Alotaibi, Altuwaym, Alnuwaysir, Alharbi, Alnajashi, Alsaber, Aldakan, Hawesa, Aldahes), College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University; from Software Development Department (Yaqob), N24 Company Limited, Riyadh; and from the Department of Radiological Sciences (Abdelgabar), Al-Ghad International Colleges for Applied Sciences, Madina, Kingdom of Saudi Arabia.
| | - Renad B. Alharbi
- From the Department of Radiological Sciences (Hassan, Alotaibi, Altuwaym, Alnuwaysir, Alharbi, Alnajashi, Alsaber, Aldakan, Hawesa, Aldahes), College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University; from Software Development Department (Yaqob), N24 Company Limited, Riyadh; and from the Department of Radiological Sciences (Abdelgabar), Al-Ghad International Colleges for Applied Sciences, Madina, Kingdom of Saudi Arabia.
| | - Lama M. Alnajashi
- From the Department of Radiological Sciences (Hassan, Alotaibi, Altuwaym, Alnuwaysir, Alharbi, Alnajashi, Alsaber, Aldakan, Hawesa, Aldahes), College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University; from Software Development Department (Yaqob), N24 Company Limited, Riyadh; and from the Department of Radiological Sciences (Abdelgabar), Al-Ghad International Colleges for Applied Sciences, Madina, Kingdom of Saudi Arabia.
| | - Mayer K. Alsaber
- From the Department of Radiological Sciences (Hassan, Alotaibi, Altuwaym, Alnuwaysir, Alharbi, Alnajashi, Alsaber, Aldakan, Hawesa, Aldahes), College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University; from Software Development Department (Yaqob), N24 Company Limited, Riyadh; and from the Department of Radiological Sciences (Abdelgabar), Al-Ghad International Colleges for Applied Sciences, Madina, Kingdom of Saudi Arabia.
| | - Hetaf F. Aldakan
- From the Department of Radiological Sciences (Hassan, Alotaibi, Altuwaym, Alnuwaysir, Alharbi, Alnajashi, Alsaber, Aldakan, Hawesa, Aldahes), College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University; from Software Development Department (Yaqob), N24 Company Limited, Riyadh; and from the Department of Radiological Sciences (Abdelgabar), Al-Ghad International Colleges for Applied Sciences, Madina, Kingdom of Saudi Arabia.
| | - Halima M. Hawesa
- From the Department of Radiological Sciences (Hassan, Alotaibi, Altuwaym, Alnuwaysir, Alharbi, Alnajashi, Alsaber, Aldakan, Hawesa, Aldahes), College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University; from Software Development Department (Yaqob), N24 Company Limited, Riyadh; and from the Department of Radiological Sciences (Abdelgabar), Al-Ghad International Colleges for Applied Sciences, Madina, Kingdom of Saudi Arabia.
| | - Zohida A. Abdelgabar
- From the Department of Radiological Sciences (Hassan, Alotaibi, Altuwaym, Alnuwaysir, Alharbi, Alnajashi, Alsaber, Aldakan, Hawesa, Aldahes), College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University; from Software Development Department (Yaqob), N24 Company Limited, Riyadh; and from the Department of Radiological Sciences (Abdelgabar), Al-Ghad International Colleges for Applied Sciences, Madina, Kingdom of Saudi Arabia.
| | - Asma S. Aldahes
- From the Department of Radiological Sciences (Hassan, Alotaibi, Altuwaym, Alnuwaysir, Alharbi, Alnajashi, Alsaber, Aldakan, Hawesa, Aldahes), College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University; from Software Development Department (Yaqob), N24 Company Limited, Riyadh; and from the Department of Radiological Sciences (Abdelgabar), Al-Ghad International Colleges for Applied Sciences, Madina, Kingdom of Saudi Arabia.
| | - Mohammed G. Yaqob
- From the Department of Radiological Sciences (Hassan, Alotaibi, Altuwaym, Alnuwaysir, Alharbi, Alnajashi, Alsaber, Aldakan, Hawesa, Aldahes), College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University; from Software Development Department (Yaqob), N24 Company Limited, Riyadh; and from the Department of Radiological Sciences (Abdelgabar), Al-Ghad International Colleges for Applied Sciences, Madina, Kingdom of Saudi Arabia.
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Kang C, Yoon H, Park S, Kim J, Han K, Kim S, Koh H, Lee MJ, Shin HJ. Initial Abdominal CT and Laboratory Findings Prior to Diagnosis of Crohn's Disease in Children. Yonsei Med J 2022; 63:675-682. [PMID: 35748079 PMCID: PMC9226833 DOI: 10.3349/ymj.2022.63.7.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/09/2022] [Accepted: 03/20/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To identify initial abdominal computed tomography (CT) and laboratory findings prior to a diagnosis of Crohn's disease (CD) in children. MATERIALS AND METHODS In this retrospective study, patients (≤18 year-old) who were diagnosed with CD from 2004 to 2019 and had abdominal CT just prior to being diagnosed with CD were included in the CD group. Patients (≤18 years old) who were diagnosed with infectious enterocolitis from 2018 to 2019 and had undergone CT prior to being diagnosed with enterocolitis were included as a control group. We assessed the diagnostic performances of initial CT and laboratory findings for the diagnosis of CD using logistic regression and the area under the curve (AUC). RESULTS In total, 107 patients (50 CD patients, 57 control patients) were included, without an age difference between groups (median 13 years old vs. 11 years old, p=0.119). On univariate logistic regression analysis, multisegmental bowel involvement, mesenteric vessel engorgement, higher portal vein/aorta diameter ratio, longer liver longitudinal diameter, lower hemoglobin (≤12.5 g/dL), lower albumin (≤4 g/dL), and higher platelet (>320×103/µL) levels were significant factors for CD. On multivariate analysis, multisegmental bowel involvement [odds ratio (OR) 111.6, 95% confidence interval (CI) 4.778-2605.925] and lower albumin levels (OR 0.9, 95% CI 0.891-0.993) were significant factors. When these two features were combined, the AUC value was 0.985 with a sensitivity of 96% and specificity of 100% for differentiating CD. CONCLUSION Multisegmental bowel involvement on CT and decreased albumin levels can help differentiate CD from infectious enterocolitis in children prior to a definite diagnosis of CD.
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Affiliation(s)
- Choeum Kang
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Haesung Yoon
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sowon Park
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jisoo Kim
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Kyunghwa Han
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Kim
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hong Koh
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Mi-Jung Lee
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Joo Shin
- Department of Radiology, Research Institute of Radiological Science, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
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Yin Y, Zhu ZX, Li Z, Chen YS, Zhu WM. Role of mesenteric component in Crohn’s disease: A friend or foe? World J Gastrointest Surg 2021; 13:1536-1549. [PMID: 35070062 PMCID: PMC8727179 DOI: 10.4240/wjgs.v13.i12.1536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/01/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
Crohn’s disease (CD) is a complex and relapsing gastrointestinal disease with mesenteric alterations. The mesenteric neural, vascular, and endocrine systems actively take part in the gut dysbiosis-adaptive immunity-mesentery-body axis, and this axis has been proven to be bidirectional. The abnormalities of morphology and function of the mesenteric component are associated with intestinal inflammation and disease progress of CD via responses to afferent signals, neuropeptides, lymphatic drainage, adipokines, and functional cytokines. The hypertrophy of mesenteric adipose tissue plays important roles in the pathogenesis of CD by secreting large amounts of adipokines and representing a rich source of proinflammatory or profibrotic cytokines. The vascular alteration, including angiogenesis and lymphangiogenesis, is concomitant in the disease course of CD. Of note, the enlarged and obstructed lymphatic vessels, which have been described in CD patients, are likely related to the early onset submucosa edema and being a cause of CD. The function of mesenteric lymphatics is influenced by endocrine of mesenteric nerves and adipocytes. Meanwhile, the structure of the mesenteric lymphatic vessels in hypertrophic mesenteric adipose tissue is mispatterned and ruptured, which can lead to lymph leakage. Leaky lymph factors can in turn stimulate adipose tissue to proliferate and effectively elicit an immune response. The identification of the role of mesentery and the crosstalk between mesenteric tissues in intestinal inflammation may shed light on understanding the underlying mechanism of CD and help explore new therapeutic targets.
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Affiliation(s)
- Yi Yin
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Zhen-Xing Zhu
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Zhun Li
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Yu-Sheng Chen
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
| | - Wei-Ming Zhu
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China
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Mitselos IV, Fousekis FS, Lamouri C, Katsanos KH, Christodoulou DK. Current noninvasive modalities in Crohn's disease monitoring. Ann Gastroenterol 2021; 34:770-780. [PMID: 34815642 PMCID: PMC8596218 DOI: 10.20524/aog.2021.0648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/16/2021] [Indexed: 12/01/2022] Open
Abstract
Crohn’s disease (CD) is characterized by a remitting and relapsing course. Longstanding active CD may result in accumulating intestinal damage and disease-related complications. In contrast, mucosal healing is associated with significant improvement in the health-related quality of life, longer periods of disease remission and lower risk of disease progression, complications, hospitalizations, intestinal surgeries, as well as a lower risk of developing colorectal cancer. Mucosal healing, the new treatment endpoint in CD, made necessary the development of noninvasive, accurate, objective and reliable tools for the evaluation of CD activity. Ileocolonoscopy with biopsies remains the reference standard method for the evaluation of the colonic and terminal ileal mucosa. However, it is an invasive procedure with a low risk of complications, allowing the investigation of only a small part of the small bowel mucosa without being able to assess transmural inflammation. These disadvantages limit its role in the frequent follow up of CD patients. In this review, we present the currently available biomarkers and imaging modalities for the noninvasive assessment of CD activity.
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Affiliation(s)
- Ioannis V Mitselos
- Department of Gastroenterology, General Hospital of Ioannina (Ioannis V. Mitselos)
| | - Fotios S Fousekis
- Department of Gastroenterology, School of Health Sciences, University Hospital of Ioannina, Faculty of Medicine, University of Ioannina (Fotios S. Fousekis, Charikleia Lamouri, Konstantinos H. Katsanos, Dimitrios K. Christodoulou), Greece
| | - Charikleia Lamouri
- Department of Gastroenterology, School of Health Sciences, University Hospital of Ioannina, Faculty of Medicine, University of Ioannina (Fotios S. Fousekis, Charikleia Lamouri, Konstantinos H. Katsanos, Dimitrios K. Christodoulou), Greece
| | - Konstantinos H Katsanos
- Department of Gastroenterology, School of Health Sciences, University Hospital of Ioannina, Faculty of Medicine, University of Ioannina (Fotios S. Fousekis, Charikleia Lamouri, Konstantinos H. Katsanos, Dimitrios K. Christodoulou), Greece
| | - Dimitrios K Christodoulou
- Department of Gastroenterology, School of Health Sciences, University Hospital of Ioannina, Faculty of Medicine, University of Ioannina (Fotios S. Fousekis, Charikleia Lamouri, Konstantinos H. Katsanos, Dimitrios K. Christodoulou), Greece
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da Silva Moraes AC, de Freitas Moraes G, de Araújo ALE, Luiz RR, Elia C, Carneiro AJ, de Souza HSP. Abdominal ultrasonography with color Doppler analysis in the assessment of ileal Crohn's disease: comparison with magnetic resonance enterography. Intest Res 2019; 17:227-236. [PMID: 30962408 PMCID: PMC6505095 DOI: 10.5217/ir.2018.00124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 03/13/2019] [Indexed: 02/07/2023] Open
Abstract
Background/Aims Consistently defining disease activity remains a critical challenge in the follow-up of patients with Crohn’s disease (CD). We investigated the potential applicability of abdominal ultrasonography with color Doppler (USCD) analysis for the detection of morphological alterations and inflammatory activity in CD. Methods Forty-three patients with CD ileitis/ileocolitis were evaluated using USCD analysis with measurements obtained on the terminal ileum and right colon. Sonographic parameters included wall thickening, stricture, hyperemia, presence of intra-abdominal mass, and fistulas. Patients were evaluated for the clinical activity (Harvey-Bradshaw Index [HBI]), fecal calprotectin (FC) and C-reactive protein (CRP). The USCD performance was assessed using magnetic resonance enterography (MRE) as a criterion standard. Results Most measurements obtained with USCD matched the data generated with MRE; however, the agreement improved in clinically active patients where sensitivity, positive predictive value, and accuracy were >80%, considering wall thickening and hyperemia. Complications such as intestinal wall thickening, stricture formation, and hyperemia, were detected in the USCD analysis with moderate agreement with MRE. The best agreement with the USCD analysis was obtained in regard to FC, where the sensitivity, positive predictive value, and accuracy were >70%. The overall performance of USCD was superior to that of HBI, FC and CRP levels, particularly when considering thickening, stricture, and hyperemia parameters. Conclusions USCD represents a practical noninvasive and low-cost tool for evaluating patients with ileal or ileocolonic disease, particularly in clinically active CD. Therefore, USCD might become a useful asset in the follow-up of patients with CD.
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Affiliation(s)
- Antonio Carlos da Silva Moraes
- Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Antonio Luis Eiras de Araújo
- Serviço de Radiologia, Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ronir Raggio Luiz
- Instituto de Estudos de Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Celeste Elia
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Antonio Jose Carneiro
- Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Heitor Siffert Pereira de Souza
- Serviço de Gastroenterologia, Departamento de Clínica Médica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,D'Or Institute for Research and Education, Rio de Janeiro, Brazil
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