title: Contrast Enhanced Abdominal Ultrasound in the Assessment of Ileal Inflammation in Crohn's Disease: A Comparison with MR Enterography.
abstract: OBJECTIVE
  To prospectively examine the feasibility and accuracy of Contrast Enhanced Ultrasound (CEUS) in the assessment of Crohn's disease (CD) activity in the terminal ileum in comparison to Magnetic Resonance Enterography (MRE), using endoscopy as a reference standard.
  
  
  METHODS
  105 consecutive patients with alleged clinically active CD were assessed by MRE and CEUS. CEUS of the terminal ileum was performed using an intravenous microbubble contrast enhancer. Accuracy values of CEUS and MRE for the presence of active terminal ileitis were evaluated using the Receiver Operating Characteristic method, using endoscopic findings as a reference standard. Sensitivity and specificity values of MRE and CEUS were compared by the McNemar test.
  
  
  RESULTS
  CEUS was feasible in 98% of patients, MRE in all. Optimal diagnostic accuracy in CEUS was obtained at a peak intensity value of 10%, showing 100% sensitivity, 92% specificity and an accuracy of 99% in demonstrating ileal mucosal inflammation. For MRE, overall sensitivity, specificity and accuracy were, 87%, 100%, and 88%, respectively. CEUS and MRE were highly correlated in assessing length and wall thickness of the terminal ileum. CEUS identified 11 of 16 MRE-detected strictures, but no fistulae.
  
  
  CONCLUSIONS
  The accuracy of CEUS is comparable to that of MRE in the assessment of active, uncomplicated terminal ileal CD and therefore a valuable bedside alternative to MRE in the follow-up of these patients.
authors: Department of Gastroenterology, Rijnstate Hospital, Arnhem, the Netherlands.
authors: C S
authors: CS
authors: Horjus Talabur Horje
authors: Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands.
authors: R
authors: R
authors: Bruijnen
authors: Department of Epidemiology and Statistics, Rijnstate Hospital, Arnhem, the Netherlands.
authors: L
authors: L
authors: Roovers
authors: Department of Gastroenterology, Rijnstate Hospital, Arnhem, the Netherlands.
authors: M J M
authors: MJ
authors: Groenen
authors: Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands.
authors: F B M
authors: FB
authors: Joosten
authors: Department of Gastroenterology, Rijnstate Hospital, Arnhem, the Netherlands.
authors: P J
authors: PJ
authors: Wahab
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging* / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology*; D019160:Endosonography / Q000379:methods; D005260:Female; D006801:Humans; D007082:Ileum / Q000473:pathology*; D007249:Inflammation / Q000473:pathology*; D007413:Intestinal Mucosa / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media