title: The value of time-intensity curves obtained after microbubble contrast agent injection to discriminate responders from non-responders to anti-inflammatory medication among patients with Crohn's disease.
abstract: OBJECTIVE
  To assess the value of time-intensity curves obtained after sulphur hefluoride-filled microbubble contrast agent injection to discriminate responders from non-responders among patients with Crohn's disease (CD).
  
  
  METHODS
  Forty-three patients (29 male and 14 female; mean age ± SD, 48.5 ± 17.17 years) with initial diagnosis of active CD were recruited. In each patient, the therapeutic outcome was assessed after 12 weeks from the beginning of pharmacologic treatment. The terminal ileal loop was scanned after sulphur hexafluoride-filled microbubble injection, and the digital cine-clip registered during the first-pass dynamic enhancement was quantified in gray-scale levels. The percentage of maximal enhancement, time to peak enhancement, and area under the time-intensity curve in responders vs. non-responders were compared by Mann-Whitney U non-parametric test.
  
  
  RESULTS
  Responders (n = 25 patients) vs. non-responders (n = 18) differed in the area under the time-intensity curve (621.58 ± 374.53 vs. 1,199.64 ± 386.39 P < 0.05), while they did not differ in percentage of maximal enhancement (41.26 ± 15.22 vs. 43.17 ± 4.41, P = 0.25) and time to peak enhancement (11.31 ± 3.06 vs. 10.12 ± 3.47, P = 0.15).
  
  
  CONCLUSIONS
  The area under the time-intensity curve obtained after microbubble injection was the only parameter to discriminate responders from non-responders among patients with CD during pharmacologic treatment.
  
  
  CONCLUSIONS
  • Dynamic ultrasound using microbubble contrast agents can help assess inflammatory bowel disease • Time-intensity curves can assess therapeutic outcome in Crohn's disease (CD) • The area under the time-intensity curve differentiates responders from non-responders during pharmacological treatment.
authors.affiliation: Department of Radiology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy. quaia@units.it
authors.forename: Emilio
authors.initials: E
authors.lastname: Quaia
authors.forename: Biagio
authors.initials: B
authors.lastname: Cabibbo
authors.forename: Luca
authors.initials: L
authors.lastname: De Paoli
authors.forename: William
authors.initials: W
authors.lastname: Toscano
authors.forename: Gabriele
authors.initials: G
authors.lastname: Poillucci
authors.forename: Maria Assunta
authors.initials: MA
authors.lastname: Cova
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D019540:Area Under Curve; D003287:Contrast Media / Q000494:pharmacology*; D003424:Crohn Disease / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride / Q000494:pharmacology*; D013997:Time Factors; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D003287:Contrast Media; D013459:Sulfur Hexafluoride