title: Comparison between a clinical activity index (Harvey-Bradshaw-Index), laboratory inflammation markers and quantitative assessment of bowel wall vascularization by contrast-enhanced ultrasound in Crohn's disease.
abstract: OBJECTIVE
  Due to its character as a remitting inflammatory disease, patients suffering from Crohn's disease (CD) often undergo several imaging studies subjecting the mostly young patients to ionizing. Contrast enhanced ultrasound for capillary microvascular assessment might be a new diagnostic tool for identifying the activity of inflammation by ultrasound techniques.
  
  
  METHODS
  We prospectively evaluated 45 patients with proven Crohn's disease performing contrast enhanced ultrasound (CEUS) and laboratory assessment including C-reactive protein (CRP), leucocytes and hematocrit as well as calculating the Harvey-Bradshaw Index (HBI). Thereafter, we applied the quantification software Qontrast(®) to obtain contrast-enhanced sonographic perfusion maps.
  
  
  RESULTS
  Analysis of the 41 finally included patients revealed a correlation of CRP to HBI and TTP[s], respectively. Moreover, an association was found for HBI and TTP[s] and for HBI and TTP[s]/Peak [%]. Analysis of 34 patients with a Peak [%] ≥ 25 showed a close association of HBI and CRP. Besides, in these patients CRP correlated to TTP[s] and to TTP[s]/Peak [%]. We found a strong negative correlation between HBI and TTP[s] (r = -0.645, p<0.01), thus, the higher the clinical activity the shorter the time-to-peak.
  
  
  CONCLUSIONS
  Quantitative evaluation with CEUS, particularly the calculation of TTP[s] in patients with a Peak [%] ≥ 25, provides a simple method to assess the inflammatory activity in CD.
authors: Department of Interal Medicine I, Franz-Josef-Strauss-Allee 11, University of Regensburg, 93042 Regensburg, Germany. christiane.girlich@klinik.uni-regensburg.de
authors: C
authors: C
authors: Girlich
authors: D
authors: D
authors: Schacherer
authors: E M
authors: EM
authors: Jung
authors: A
authors: A
authors: Schreyer
authors: R
authors: R
authors: Büttner
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D003287:Contrast Media; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006400:Hematocrit; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D010743:Phospholipids; D011446:Prospective Studies; D012720:Severity of Illness Index; D012984:Software; D018709:Statistics, Nonparametric; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D002097:C-Reactive Protein; D013459:Sulfur Hexafluoride