title: Crohn's disease activity: quantitative contrast-enhanced ultrasound assessment.
abstract: OBJECTIVE
  To determine whether quantitative parameters from contrast-enhanced ultrasound examination (CE-US) of the bowel wall correlate with endoscopic inflammatory activity in Crohn's disease and to assess its utility in the follow-up of patients on treatment.
  
  
  METHODS
  This was a prospective study of 30 patients with Crohn's disease requiring colonoscopy or flexible sigmoidoscopy. The Crohn's disease activity index (CDAI), serum C-reactive protein (CRP) and Crohn's disease endoscopic index of severity (CDEIS) were calculated. CE-US was performed within 7 days of endoscopy using intravenous perflutren lipid microsphere and repeated a median of 45.5 days following treatment. Time-intensity curves of bowel wall enhancement were generated to derive the area under the curve (AUC), time to peak intensity (TTP) and peak intensity (PI).
  
  
  RESULTS
  In separate multivariate regression models, the AUC, TTP and PI showed no significant association with endoscopic activity whilst controlling for CDAI and CRP. However, the reductions in CDAI and CRP following treatment were mirrored by significant reductions in TTP (P = 0.05).
  
  
  CONCLUSIONS
  CE-US does not appear to predict for Crohn's disease endoscopic activity independent of simple parameters such as CDAI and CRP. However, it may be useful in the serial assessment of patients on treatment.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, WA, Australia. ddwong@optusnet.com.au
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Wong
authors.forename: Geoff M
authors.initials: GM
authors.lastname: Forbes
authors.forename: Marilyn
authors.initials: M
authors.lastname: Zelesco
authors.forename: Rose
authors.initials: R
authors.lastname: Mason
authors.forename: Janina
authors.initials: J
authors.lastname: Pawlik
authors.forename: Richard M
authors.initials: RM
authors.lastname: Mendelson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D002097:C-Reactive Protein / Q000378:metabolism; D003113:Colonoscopy; D003287:Contrast Media; D003424:Crohn Disease / Q000000981:diagnostic imaging*; D005260:Female; D005466:Fluorocarbons; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D012812:Sigmoidoscopy; D018709:Statistics, Nonparametric; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; D002097:C-Reactive Protein; C042852:perflutren