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Contrast-enhanced ultrasonographic evaluation of inflammatory activity in Crohn's disease

Migaleddu, Vincenzo and Scanu, Antonio Mario and Quaia, Emilio and Cossu Rocca, Paolo Alessandro and Dore, Maria Pina and Scanu, Domenico and Azzali, Lorenza and Virgilio, Giuseppe (2009) Contrast-enhanced ultrasonographic evaluation of inflammatory activity in Crohn's disease. Gastroenterology, Vol. 137 (1), p. 43-52. ISSN 0016-5085. Article.

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DOI: 10.1053/j.gastro.2009.03.062


Background & Aims. We sought to test the diagnostic accuracy of ultrasound (US), color Doppler US (CD-US), and contrast-enhanced US (CE-US) in the evaluation of inflammatory activity in patients with Crohn's disease (CD), and to correlate the findings of these sonographic studies with inflammatory activity, as scored by the CD activity index (CDAI).
Methods. Patients with CD were enrolled in the study. Radiologists performing the scans were blinded to clinical status. Baseline US, CD-US, and CE-US examinations were conducted with high-frequency probes (8–14 and 5–7 MHz) before and after injection of sulfur hexafluoride-filled microbubbles. The diagnostic accuracy of baseline US, CD-US, and CE-US were calculated by using the endoscopic and histologic findings as reference standards and correlated with the CDAIs by using the Pearson linear correlation coefficient.
Results. Forty-seven patients (20 men; 27 women; mean age ± SD, 38 ± 14 years) with a CDAI > 150 (n = 30) or < 150 (n = 17), were recruited. CE-US showed the highest performance, with 93.5% sensitivity, 93.7% specificity, and 93.6% overall accuracy. CE-US revealed 3 bowel wall perfusion patterns after microbubble injection: submucosal enhancement and inward and outward transparietal enhancement. The linear correlation coefficient for CE-US versus CDAI was 0.74 (P < .0001); for baseline US (assessing thickness, length, and multilayer appearance of the diseased bowel) versus the CDAI, the coefficients were 0.68 (P < .0001), 0.47 (P = .0009), and 0.60 (P < .0001), respectively; and for CD-US versus CDAI the coefficient was 0.73 (P < .0001).
Conclusions. CE-US has a high sensitivity and specificity in detecting inflammatory activity and a strong correlation with the CDAI.

Item Type:Article
ID Code:3529
Uncontrolled Keywords:Crohn's disease, inflammatory activity, color doppler
Subjects:Area 06 - Scienze mediche > MED/12 Gastroenterologia
Area 06 - Scienze mediche > MED/08 Anatomia patologica
Area 06 - Scienze mediche > MED/18 Chirurgia generale
Divisions:001 Università di Sassari > 03 Istituti > Clinica medica generale e terapia medica
002 Altri enti e centri di ricerca del Nord Sardegna > SMIRG-Sardinian Mediterranean Imaging Research Group, Sassari
001 Università di Sassari > 03 Istituti > Clinica chirurgica generale e terapia chirurgica
001 Università di Sassari > 03 Istituti > Anatomia patologica
Copyright Holders:© 2009 AGA Institute
Deposited On:25 Jan 2010 16:42

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