Contrast-enhanced wideband harmonic imaging ultrasound (SonoVue): a new technique for quantifying bowel wall vascularity in Crohn's disease.
OBJECTIVE
To assess the possibility of quantitative determination of bowel wall vascularity using contrast-enhanced (SonoVue) wideband harmonic imaging ultrasound and the HDI-Lab software in patients with Crohn's disease.


METHODS
Twenty-one patients (13 F, 8 M, average age 33.8+/-12.7 years, range 21-60 years) with histologically confirmed Crohn's disease and bowel wall thickness > or -5 mm were recruited for the study. All ultrasound examinations were performed using a Philips HDI 5000 scanner. Bowel wall vascularity was determined at the site of maximum bowel wall thickness at baseline and at 30, 60, 90 and 120 s following application of the contrast enhancer SonoVue (1.2 ml) using the HDI-Lab software.


RESULTS
The mean length of bowel segments exhibiting increased wall thickness was 122.3 mm (range: 23-350+/-74.7 mm), with a mean wall thickness of 7.6+/-1.2 mm. Onset of echo enhancement secondary to contrast medium application was observed after an average 13.4 s (range 7-19+/-4.2 s). Echo intensity corresponding to maximum vascularity was measured 30 s after application of contrast medium. Maximum average contrast medium uptake was 217.5% (range 118-466+/-100.1%).


CONCLUSIONS
It is possible to quantify bowel wall vascularity accurately in patients with Crohn's disease using contrast-enhanced pulse inversion ultrasound (low-MI).
Kratzer
Wolfgang
W
Abteilung Innere Medizin I, Universität Ulm, Robert-Koch-Str. 8, DE-89081 Ulm, Germany. wolfgang.kratzer@medizin.uni-ulm.de
Schmidt
Stefan A
SA
Mittrach
Christoph
C
Haenle
Mark M
MM
Mason
Richard A
RA
Von Tirpitz
Christian
C
Pauls
Sandra
S
D000328:Adult; D003424:Crohn Disease / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007079:Ileitis / Q000000981:diagnostic imaging*; D007082:Ileum / Q000098:blood supply* / Q000000981:diagnostic imaging; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000008:administration & dosage; D011446:Prospective Studies; D015203:Reproducibility of Results; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D018608:Ultrasonography, Doppler / Q000379:methods*
D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride