Laura Scopelliti

Comparison of US Strain Elastography and Entero-MRI to Typify the Mesenteric and Bowel Wall Changes during Crohn’s Disease: A Pilot Study

Purpose To evaluate and compare the mesenteric and bowel wall changes during Crohns disease (CD) on ultrasonography (US) Strain Elastography (SE) and Enterography Magnetic Resonance Imaging (E-MRI). Methods From July 2014 to September 2016, 35 patients with ileocolonoscopy diagnosis of CD were prospectively examined with E-MRI and in the same time with US and SE. Results A total of 41 affected bowel segments and 35 unaffected bowel segments in 35 patients were evaluated. US-SE color-scale coding showed a blue color pattern in the fibrotic mesentery and bowel wall in 15 patients and a green color pattern in the edematous ones in 20 patients. The signal of the bowel wall and mesenteric fat was iso/hypointense on T2-weighted sequence in the fibrotic pattern (23/35 and 12/35 patients) and hyperintense in the edematous pattern (12/35 and 23/35 patients). Mean ADC values were, respectively, 2,58 ± 0,33 × 10−3 for the fibrotic mesentery and 2,14 ± 0,28 × 10−3 for edematous one. There was a statistical correlation between US-SE color-scale and T2 signal intensity and between the US-SE color-scale and ADC maps. Conclusions US-SE, ADC, and signal intensity on T2-weighted sequences on MR prove to be useful tools for the evaluation of CD pattern.

A Kernel Support Vector Machine Based Technique for Crohn’s Disease Classification in Human Patients

In this paper a new technique for classification of patients affected by Crohn’s disease (CD) is proposed. The proposed technique is based on a Kernel Support Vector Machine (KSVM) and it adopts a Stratified K-Fold Cross-Validation strategy to enhance the KSVM classifier reliability. Traditional manual classification methods require radiological expertise and they usually are very time-consuming. Accordingly to three expert radiologists, a dataset composed of 300 patients has been selected for KSVM training and validation. Each patient was codified by 22 extracted qualitative features and classified as Positive or Negative as the related histological specimen result showed the CD. The effectiveness of the proposed technique has been proved using a real human patient dataset collected at the University of Palermo Policlinico Hospital (UPPH dataset) and composed of 300 patients. The KSVM classification results have been compared against the histological specimen results, which are the adopted Ground-Truth for CD diagnosis. The achieved results (Sensitivity: 94,80%; Specificity: 100,00%; Negative Predictive Value: 95,06%; Precision: 100,00%; Accuracy: 97,40%; Error: 2,60%) show that the proposed technique results are comparable or even better than manual reference methods reported in literature.

The Videofluorographic Swallowing Study in Rheumatologic Diseases: A Comprehensive Review

Autoimmune connective tissue diseases are a heterogeneous group of pathologies that affect about 10% of world population with chronic evolution in 20%–80%. Inflammation in autoimmune diseases may lead to serious damage to other organs including the gastrointestinal tract. Gastrointestinal tract involvement in these patients may also due to both a direct action of antibodies against organs and pharmacological therapies. Dysphagia is one of the most important symptom, and it is caused by failure of the swallowing function and may lead to aspiration pneumonia, malnutrition, dehydration, weight loss, and airway obstruction. The videofluorographic swallowing study is a key diagnostic tool in the detection of swallowing disorders, allowing to make an early diagnosis and to reduce the risk of gastrointestinal and pulmonary complications. This technique helps to identify both functional and structural anomalies of the anatomic chain involved in swallowing function. The aim of this review is to systematically analyze the basis of the pathological involvement of the swallowing function for each rheumatological disease and to show the main features of the videofluorographic study that may be encountered in these patients.