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Ileal Crohn Disease: Mural Microvascularity Quantified with Contrast-enhanced US Correlates with Disease Activity.
MedLine Citation:
PMID:  22157203     Owner:  NLM     Status:  Publisher    
Purpose:To quantitatively assess microvascular activation in the thickened ileal walls of patients with Crohn disease (CD) by using contrast-enhanced ultrasonography (US) and evaluate its correlation with widely used indexes of CD activity.Materials and Methods:This prospective study was approved by the ethics committee, and written informed consent was obtained from all patients. The authors examined 54 consecutively enrolled patients (mean age, 35.29 years; age range, 18-69 years; 39 men, 15 women) with endoscopically confirmed CD of the terminal ileum. Ileal wall segments thicker than 3 mm were examined with low-mechanical-index contrast-enhanced US and a second-generation US contrast agent. The authors analyzed software-plotted time-enhancement intensity curves to determine the maximum peak intensity (MPI) and wash-in slope coefficient (β) and evaluated their correlation with (a) the composite index of CD activity (CICDA), (b) the CD activity index (CDAI), and (c) the simplified endoscopic score for CD (SES-CD, evaluated in 37 patients) for the terminal ileum. Statistical analysis was performed with the Mann-Whitney test, Spearman rank test, and receiver operating characteristic (ROC) analysis.Results:MPI and β coefficients were significantly increased in the 36 patients with a CICDA indicative of active disease (P < .0001 for both), the 33 patients with a CDAI of at least 150 (P < .032 and P < .0074, respectively), and the 26 patients with an SES-CD of at least 1 (P < .0001 and P < .002, respectively). ROC analysis revealed accurate identification (compared with CICDA) of active CD with an MPI threshold of 24 video intensity (VI) (sensitivity, 97%; specificity, 83%) and a β coefficient of 4.5 VI/sec (sensitivity, 86%; specificity, 83%).Conclusion:Contrast-enhanced US of the ileal wall is a promising method for objective, reproducible assessment of disease activity in patients with ileal CD.© RSNA, 2011.
Antonio De Franco; Alessandra Di Veronica; Alessandro Armuzzi; Italia Roberto; Manuela Marzo; Barbara De Pascalis; Italo De Vitis; Alfredo Papa; Enrico Bock; Francesco M Danza; Lorenzo Bonomo; Luisa Guidi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-12
Journal Detail:
Title:  Radiology     Volume:  -     ISSN:  1527-1315     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Bioimaging and Radiologic Science, Radiodiagnostics-Echography Service, Complesso Integrato Columbus, and Department of Internal Medicine and Gastroenterology, Complesso Integrato Columbus, Università Cattolica del Sacro Cuore, Largo Francesco Vito 8, 00161 Rome, Italy. the 2008 and 2010 RSNA Annual Meetings.
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