PWE-020 Initial experience of a rapid access ultrasound imaging clinic in inflammatory bowel disease

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Abstract

Introduction

Although less widely used than MRI in UK practice, Ultrasound offers a number of advantages in the assessment of inflammatory bowel disease. It is quick to perform and requires minimal preparation allowing it to be performed at short notice. It is dynamic and clinically interactive allowing immediate correlation of patient’s symptoms with imaging findings. It provides assessment of disease activity/complications together with dynamic assessment of functional obstruction. Results are immediately available allowing instantaneous clinical decision making. We present our initial experience of using Ultrasound in a rapid access imaging clinic and its effects on patient management.

Methods

Patients were referred from either clinic, endoscopy or via IBD specialist nurse direct access/telephone advice line. Dedicated slots were allocated on Ultrasound lists, and appointments directly booked by the IBD nurse. All referrals were made on the basis of possible new diagnosis of IBD, assessment of disease extent following endoscopic diagnosis or known patient with IBD with possible exacerbation/complications. All patients were scanned by a single Consultant GI Radiologist in the presence of the IBD specialist nurse. Findings were immediately communicated to patient and nurse and immediate combined decision made with regard to necessity for treatment change and urgency of further follow up.

Results

54 patients were examined: – Male: Female 21:33. Age range 17–79 years. 48% of patients were examined within 7 days and 69% within 14 days of referral. Ultrasound detected active disease/complications in 65%. Ultrasound findings resulted 43% of patients undergoing significant change in management with 41% also requiring dietetic referral. 29% required urgent follow up within 1 week including 3 patients that required immediate Consultant review after the scan. 9 patients (17%) required further imaging with CT/MR during the course of their follow up.

Conclusions

Our experience demonstrates that using a combined multi-disciplinary clinico- radiological approach with Ultrasound as the primary imaging modality in IBD offers a number of advantages. These include rapid access and flexibility of imaging appointments, minimal patient preparation and instantaneous availability of results allowing immediate feedback and patient counselling. It provides the opportunity for urgent treatment changes and triage of follow up appointment scheduling. Wider adoption of Ultrasound in IBD has the potential to offer significant improvement in speed of diagnosis and patient management.

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