Contrast-enhanced ultrasonography for the determination of Crohn's disease activity - preliminary experience.
BACKGROUND
Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn's disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD.


METHODS
Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR).


RESULTS
Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation.


CONCLUSIONS
CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn's disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI.
Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Marcin
M
Białecki
Department of Dermatology, Sexually Transmitted Diseases and Immunodermatology, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Agnieszka
A
Białecka
Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Katarzyna
K
Laskowska
Center of Interventional Endoscopy, Outpatients' Department of Bowel Diseases, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Maria
M
Kłopocka
Center of Interventional Endoscopy, Outpatients' Department of Bowel Diseases, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Ariel
A
Liebert
Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Adam
A
Lemanowicz
Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Zbigniew
Z
Serafin
CEUS; Crohn’s Disease; IBS