Diagnostic algorithms for the examination of patients with inflammatory bowel diseases

Aim. To determine the diagnostic information content of various research methods for diagnosis, differential diagnosis, and determination of the degree of activity of inflammatory bowel diseases. Materials and methods. 210 patients with ulcerative colitis (UC) and Crohn’s disease (CD) were examined. All patients underwent endoscopic colon examination using virtual chromoscopy (NBI) and autofluorescence (AFI), endosonographic examination (EUS), transabdominal ultrasound and computed tomography (CT) of the colon. The indicators of diagnostic and prognostic significance of the methods were calculated. Results. The results obtained during the study showed that the most informative methods for detecting UC and CD are NBI (UC: Se= 81%, Sp= 71%, BC: Se = 75%, Sp= 70%) and EUS (UC: Se = 90%, Sp= 81%, BC: Se = 74%, Sp= 80%). The above methods were also diagnostically and prognostically significant for the differential diagnosis of UC and CD (NBI: Se = 81%, Sp= 73%, EUS: Se = 81%, Sp= 74%). Clarifying the severity of UC inflammation through various examination methods showed the informative value of three methods: NBI (Se = 79%, Sp= 71%), EUS (Se = 86%, Sp= 67%) and CT (Se = 78%, Sp= 61%). Similar data were obtained when identifying the inflammatory phase of CD NBI (Se = 75%, Sp= 71%), EUS (Se = 71%, Sp= 64%) and CT (Se = 74%, Sp= 66%). The detection of neoplasia showed low figures of diagnostic significance of all radiation methods, while both NBI and API were informative (Se = 100%, Sp= 95%; Se = 87%, Sp= 80%, respectively). Conclusion. Summarizing the data obtained, algorithms for the diagnosis of IBD were developed at various stages of the examination of patients.

inflammatory bowel diseases, ulcerative colitis, Crohn’s disease, virtual chromoscopy, autofluorescence, colon endosonography, transabdominal ultrasound, computed tomography

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