title: Differentiation of Inflammatory from Fibrotic Ileal Strictures among Patients with Crohn's Disease through Analysis of Time-Intensity Curves Obtained after Microbubble Contrast Agent Injection.
abstract: The aim of the study described here was to assess whether the analysis of time-intensity curves obtained after microbubble contrast agent injection could differentiate inflammatory from fibrotic ileal strictures among patients with Crohn's disease. Sixty-five consecutive patients (40 male and 25 female; mean age ± SD, 42.2 ± 12.22 y) with stricture of the terminal ileal loop from Crohn's disease were scanned after microbubble injection. Time-intensity curves were obtained from quantitative analysis, and peak enhancement, rise time, time to peak, area under the time-intensity curve (AUC), AUC during wash-in (AUCWI) and AUC during wash-out (AUCWO) were compared between patients with inflammatory strictures and patients with fibrotic strictures. Inflammatory (n = 40) and fibrotic (n = 25) strictures differed (p < 0.05) in peak enhancement, wash-in rate, wash-in perfusion index, AUC, AUCWI and AUCWO. The quantitative analysis of small bowel wall contrast enhancement after microbubble contrast agent injection may differentiate inflammatory from fibrotic ileal strictures in patients with Crohn's disease.
authors.affiliation: Edinburgh Imaging Facility, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland. Electronic address: equaia@exseed.ed.ac.uk.
authors.forename: Emilio
authors.initials: E
authors.lastname: Quaia
authors.affiliation: Department of Radiology, Cattinara Hospital, University of Trieste, Trieste, Italy.
authors.forename: Antonio Giulio
authors.initials: AG
authors.lastname: Gennari
authors.affiliation: Edinburgh Imaging Facility, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland.
authors.forename: Edwin J R
authors.initials: EJR
authors.lastname: van Beek
mesh_terms: D000328:Adult; D003198:Computer Simulation; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D003287:Contrast Media / Q000493:pharmacokinetics; D003424:Crohn Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism*; D003937:Diagnosis, Differential; D005260:Female; D005355:Fibrosis / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007079:Ileitis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008657:Metabolic Clearance Rate; D008954:Models, Biological; D010743:Phospholipids / Q000493:pharmacokinetics*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride / Q000493:pharmacokinetics*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
keywords: Crohn's; Fibrosis; Microbubbles; Ultrasound