Evaluating bowel wall vascularity in Crohn's disease: a comparison of dynamic MRI and wideband harmonic imaging contrast-enhanced low MI ultrasound.
This was a prospective comparison of dynamic MRI (1.5 T) and echo-signal enhanced ultrasound in evaluating vascularization in thickened bowel walls cases of Crohn's disease. Twenty-one patients with histologically confirmed Crohn's disease and bowel wall diameters >5 mm were examined by MRI and ultrasound (US). MR sequences: T1w fl2D, T2w, FLASH T1w post-contrast media (CM) applications with fat saturation were used. Dynamic Turbo-FLASH T1w sequences were acquired in the area of maximal thickening of the ileal wall every 1.5 s post-CM application for a total duration of 1 min. US was performed after the application of 1.2 ml of echo-signal enhancer. Contrast uptake was measured by the semiquantitative score and brightness analysis in regions of interest (ROI). Clinical and laboratory findings including Crohn's disease activity indices were documented; MRI and US parameters were correlated. The length of sonographically documented lesions (122+/-75 mm) correlated significantly with the length of thickened bowel segments in MRI (128+/-76 mm; r=0.466; P=0.033). The maximum percent signal enhancement in the terminal ileum at ultrasound (217.5+/-100.1%) showed a high correlation with the findings of MRI (262+/-108%; r=0.623; P=0.003). With both methods, a plateau phase was observed. US and MRI are capable of evaluating local vascularization in the bowel wall objectively.
Pauls
Sandra
S
Department of Diagnostic Radiology, University of Ulm, Robert-Koch-Str. 8, 89081, Ulm, Germany. sandra.pauls@uniklinik-ulm.de
Gabelmann
Andreas
A
Schmidt
Stefan A
SA
Rieber
Andrea
A
Mittrach
Christoph
C
Haenle
Mark M
MM
Brambs
Hans-Jürgen
HJ
Kratzer
Wolfgang
W
D000328:Adult; D016477:Artifacts; D003287:Contrast Media / Q000008:administration & dosage* / Q000378:metabolism; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000008:administration & dosage / Q000378:metabolism; D011446:Prospective Studies; D012720:Severity of Illness Index; D013459:Sulfur Hexafluoride / Q000008:administration & dosage / Q000378:metabolism; D018084:Ultrasonography, Interventional
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride