Bowel Ultrasound Normal Vs Crohn's Disease | Limberg Score, SUS-CD System & Other USG Findings скачать в хорошем качестве

Bowel Ultrasound Normal Vs Crohn's Disease | Limberg Score, SUS-CD System & Other USG Findings

Support the channel on Patreon: patreon.com/drsamsimaginglibrary Bowel Ultrasound Normal Vs Crohn's Disease | Limberg Score, SUS-CD System & Other USG Findings Crohn Disease Lab Findings: Inflammation: ↑ CRP, ↑ ESR, ↑ WBC, ↑ Platelets Anemia: Iron deficiency, B12/folate deficiency, anemia of chronic disease Nutrition: ↓ Albumin, ↓ vitamins/minerals (B12, D, iron, folate, calcium, magnesium) Fecal markers: ↑ Fecal calprotectin, ↑ fecal lactoferrin Serology: ASCA-positive (supportive, not diagnostic) Normal Terminal Ileum Layers: Mucosal/Lumen Interface (Superficial Mucosa): Echogenic Muscularis Mucosa (Deep Mucosa): Hypoechoic Submucosa: Echogenic Muscularis Propria: Hypoechoic Serosa: Echogenic Crohn Disease: Wall thickness Greater than 3 mm Typically affects terminal ileum and right colon (caecum, ascending colon). In acute active inflammation, wall stratification may be preserved or accentuated. In chronic disease/fibrosis, stratification is often lost. Creeping fat: Hyperechoic mesenteric fat wrapping around bowel loops. Loss of wall stratification (layered appearance) Mesenteric lymphadenopathy: Usually multiple, oval, hypoechoic, non-necrotic enlarged lymph nodes Increased bowel wall vascularity (hyperemia) indicates active inflammation. Limberg score Grade 0: Wall Thickness Less than 3 mm No loss of wall stratification No doppler signals in bowel wall Limberg score Grade 1: Wall thickness Greater than 3 mm Partial loss of wall stratification No doppler signals in bowel wall Limberg Score Grade 2: Few doppler signals in bowel wall Limberg Score Grade 3: Stronger vascularity, more doppler signals present. Limberg Score Grade 4: Blood flow present in both bowel wall and mesenteric fat. SUS-CD: The Simple Ultrasound Activity Score for Crohn’s Disease (SUS-CD) is a validated scoring system developed to non-invasively assess Crohn’s disease activity using ultrasound. It emphasizes two easily measurable, reproducible ultrasound parameters Bowel Wall Thickness Scored segment by segment: 0 points: Less than 3.0 mm 1 point: 3.0–4.9 mm 2 points: 5.0–7.9 mm 3 points: ≥ 8.0 mm Color Doppler Signals: 1: Increased Doppler signal in less than half the circumference on a transverse image 2: Increased Doppler signal in more than half the circumference on a transverse image Total Score: For each bowel segment (e.g., ileum, colon subsegments), the SUS-CD score equals: BWT (0–3) + CDS (0–2) = 0 to 5 points per segment A sum across segments provides an overall disease activity measure. Segments Evaluated: Terminal ileum Right colon (cecum + ascending) Transverse colon Left colon (descending + sigmoid) Rectum Score Interpretation: 0–1 → Normal or very mild disease 2–3 → Moderate activity 4–5 → Severe active disease Fistulas: Hypoechoic tracts between bowel loops, bladder, skin, or other structures; may show gas or fluid inside. Abscesses: Hypoechoic/anechoic collections with irregular walls, sometimes internal echoes (debris, gas with dirty shadowing). Strictures: Fixed narrowed segment with prestenotic dilatation ( greater than 25–30 mm bowel diameter).