title: Dynamic Contrast-Enhanced Magnetic Resonance Enterography and Dynamic Contrast-Enhanced Ultrasonography in Crohn's Disease: An Observational Comparison Study.
abstract: Purposee Cross-sectional imaging methods are important for objective evaluationof small intestinal inflammationinCrohn'sdisease(CD).The primary aim was to compare relative parameters of intestinal perfusion between contrast-enhanced ultrasonography (CEUS) and dynamic contrast-enhanced magnetic resonance enterography (DCE-MRE) in CD. Furthermore, we aimed at testing the repeatability of regions of interest (ROIs) for CEUS.MethodsThis prospective study included 25 patients: 12 females (age: 37, range: 19-66) with moderate to severe CD and a bowel wall thickness>3mm evaluated with DCE-MRE and CEUS. CEUS bolus injection was performed twice for repeatability and analyzed in VueBox®. Correlations between modalities were described with Spearman's rho, limits of agreement(LoA) and intraclass correlation coefficient(ICC). ROIrepeatability for CEUS was assessed.Resultss The correlation between modalities was good and very good for bowel wall thickness (ICC=0.71, P<0.001) and length of the inflamed segment (ICC=0.89, P<0.001). Moderate-weak correlations were found for the time-intensity curve parameters: peak intensity (r=0.59, P=0.006), maximum wash-in-rate (r=0.62, P=0.004), and wash-in perfusion index (r=0.47, P=0.036). Best CEUS repeatability for peak enhancement was a mean difference of 0.73 dB (95% CI: 0.17 to 1.28, P=0.01) and 95% LoA from -3.8 to 5.3 dB. Good quality of curve fit improved LoA to -2.3 to 2.8 dB.ConclusionThe relative perfusion of small intestinal CD assessed with DCE-MRE and CEUS shows only a moderate correlation. Applying strict criteria for ROIs is important and allows for good CEUS repeatability.
authors.affiliation: Divisions of Medicine and Radiology, Diagnostic Centre, Silkeborg Regional Hospital, University Research Clinic for Innovative Diagnostic Pathways, Silkeborg, Denmark; Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: Rune
authors.initials: R
authors.lastname: Wilkens
authors.affiliation: Department of Clinical Engineering, Aarhus University Hospital, Aarhus N, Denmark.
authors.forename: David A
authors.initials: DA
authors.lastname: Peters
authors.affiliation: Divisions of Medicine and Radiology, Diagnostic Centre, Silkeborg Regional Hospital, University Research Clinic for Innovative Diagnostic Pathways, Silkeborg, Denmark.
authors.forename: Agnete H
authors.initials: AH
authors.lastname: Nielsen
authors.affiliation: Divisions of Medicine and Radiology, Diagnostic Centre, Silkeborg Regional Hospital, University Research Clinic for Innovative Diagnostic Pathways, Silkeborg, Denmark.
authors.forename: Valeriya P
authors.initials: VP
authors.lastname: Hovgaard
authors.affiliation: Divisions of Medicine and Radiology, Diagnostic Centre, Silkeborg Regional Hospital, University Research Clinic for Innovative Diagnostic Pathways, Silkeborg, Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Glerup
authors.affiliation: Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus C, Denmark.
authors.forename: Klaus
authors.initials: K
authors.lastname: Krogh
keywords: Crohn’s disease; contrast media; magnetic resonance imaging; reproducibility of results; ultrasonography