CEUS will be an area of future development for children with Crohn disease and is currently being used clinically by several committee members to supplement US abdomen (without IV contrast) for monitoring and surveillance imaging. In this setting, CEUS is most useful in Crohn disease patients with a single segment of bowel involvement that is sonographically visible. Another avenue of potential future development that may supplement CEUS is determining the role to US shear wave elastography in pediatric patients, as literature is starting to emerge in adults [44]. WBC Scan Whole Body Tc-99m HMPAO WBC scan studies show sensitivities from 75% to 94% and specificities from 92% to 99% for intestinal inflammation in children [45]. More recently, Chroustova et al [46] found a sensitivity of 89% and a specificity of 91% in 85 children. Although the diagnostic parameters of a WBC scan whole body are useful for both diagnosis and disease activity assessment, significant practical limitations exist. One disadvantage is the Crohn Disease-Child decreased ability to detect and evaluate alternative diagnoses. Other significant disadvantages are the technical aspects including volume of blood required for labeling, longer acquisition times, and significantly limited usage for initial diagnosis. Variant 4: Child. Known Crohn disease, perianal fistula. Initial imaging. Perianal Crohn disease manifesting as either a fistula or an abscess is common, with 15% to 25% of patients exhibiting perianal Crohn disease in childhood and 38% during their lifetime [5,6]. Although examination under anesthesia by a pediatric surgeon has been a standard of care for assessment, advancements in imaging complement the clinical assessment. Imaging may also supplant examination under anesthesia in circumstances when noninvasive diagnostic information is sought, such as preprocedural planning or assessment of therapy response [2].
Crohn Disease Child. CEUS will be an area of future development for children with Crohn disease and is currently being used clinically by several committee members to supplement US abdomen (without IV contrast) for monitoring and surveillance imaging. In this setting, CEUS is most useful in Crohn disease patients with a single segment of bowel involvement that is sonographically visible. Another avenue of potential future development that may supplement CEUS is determining the role to US shear wave elastography in pediatric patients, as literature is starting to emerge in adults [44]. WBC Scan Whole Body Tc-99m HMPAO WBC scan studies show sensitivities from 75% to 94% and specificities from 92% to 99% for intestinal inflammation in children [45]. More recently, Chroustova et al [46] found a sensitivity of 89% and a specificity of 91% in 85 children. Although the diagnostic parameters of a WBC scan whole body are useful for both diagnosis and disease activity assessment, significant practical limitations exist. One disadvantage is the Crohn Disease-Child decreased ability to detect and evaluate alternative diagnoses. Other significant disadvantages are the technical aspects including volume of blood required for labeling, longer acquisition times, and significantly limited usage for initial diagnosis. Variant 4: Child. Known Crohn disease, perianal fistula. Initial imaging. Perianal Crohn disease manifesting as either a fistula or an abscess is common, with 15% to 25% of patients exhibiting perianal Crohn disease in childhood and 38% during their lifetime [5,6]. Although examination under anesthesia by a pediatric surgeon has been a standard of care for assessment, advancements in imaging complement the clinical assessment. Imaging may also supplant examination under anesthesia in circumstances when noninvasive diagnostic information is sought, such as preprocedural planning or assessment of therapy response [2].