Abstract
Purpose
To examine the imaging characteristics of intestinal tuberculosis by conventional ultrasound and contrast-enhanced ultrasound (CEUS).
Materials and methods
Characteristics of the conventional and contrast-enhanced ultrasound images of 31 patients with intestinal tuberculosis confirmed by surgery were retrospectively examined. CEUS was used to evaluate the pattern of the bowel wall enhancement.
Results
Of the 31 patients with intestinal tuberculosis (IT), 27 had infections located at the ileocecum and 4 at the hepatic flexure of the colon. Conventional ultrasound showed that the mean thickening of bowel wall was 1.38 cm, ranging from 0.56 to 2.20 cm. Two types of bowel wall enhancement patterns on CEUS were observed. For 13 % of the patients (4/31), the serosa was quickly enhanced first, then the mucosa was enhanced gradually (type 1 enhancement). In the remaining 27 patients, the whole bowel wall was quickly diffusely enhanced (type 2 enhancement). In addition, the enhancement of the thickened bowel wall was homogeneous in 9 patients, while the others showed inhomogeneous enhancement.
Conclusion
CEUS found detailed patterns of bowel wall enhancement of intestinal tuberculosis and had the potential to provide useful information for the diagnosis of suspected patients.
Similar content being viewed by others
References
Zumla A, George A, Sharma V, Herbert N, Baroness Masham of I. WHOʼs, 2013 global report on tuberculosis: successes, threats, and opportunities. Lancet. 2013;382:1765–7.
Sheer TA, Coyle WJ. Gastrointestinal tuberculosis. Curr Gastroenterol Rep. 2003;5:273–8.
Vanhoenacker FM, De Backer AI, de Op BB, Maes M, Van Altena R, Van Beckevoort D, et al. Imaging of gastrointestinal and abdominal tuberculosis. Eur Radiol. 2004;14(Suppl 3):E103–15.
Barreiros AP, Braden B, Schieferstein-Knauer C, Ignee A, Dietrich CF. Characteristics of intestinal tuberculosis in ultrasonographic techniques. Scand J Gastroenterol. 2008;43:1224–31.
Paredes JM, Ripolles T, Cortes X, Moreno N, Martinez MJ, Bustamante-Balen M, et al. Contrast-enhanced ultrasonography: usefulness in the assessment of postoperative recurrence of Crohnʼs disease. J Crohns Colitis. 2013;7:192–201.
Wilson SR, Burns PN. Microbubble-enhanced US in body imaging: what role? Radiology. 2010;257:24–39.
Badea R, Socaciu M, Ciobanu L, Hagiu C, Golea A. Contrast-enhanced ultrasonography (CEUS) for the evaluation of the inflammation of the digestive tract wall. J Gastrointestin Liver Dis. 2010;19:439–44.
Horvath KD, Whelan RL. Intestinal tuberculosis: return of an old disease. Am J Gastroenterol. 1998;93:692–6.
Corbett EL, Watt CJ, Walker N, Maher D, Williams BG, Raviglione MC, et al. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med. 2003;163:1009–21.
Valadas E, Antunes F. Tuberculosis, a re-emergent disease. Eur J Radiol. 2005;55:154–7.
Leung VK, Law ST, Lam CW, Luk IS, Chau TN, Loke TK, et al. Intestinal tuberculosis in a regional hospital in Hong Kong: a 10-year experience. Hong Kong Med J. 2006;12:264–71.
Chong VH, Lim KS. Gastrointestinal tuberculosis. Singapore Med J. 2009;50:638–45 (quiz 46).
Ismail Y, Muhamad A. Protean manifestations of gastrointestinal tuberculosis. Med J Malaysia. 2003;58:345–9.
Walia HS, Khafagy AR, al-Sayer HM, Walia HK, al-Nakib B, Sivanandan R. Unusual presentations of abdominal tuberculosis. Can J Surg. 1994;37:300–6.
Klimach OE, Ormerod LP. Gastrointestinal tuberculosis: a retrospective review of 109 cases in a district general hospital. Q J Med. 1985;56:569–78.
Sherman S, Rohwedder JJ, Ravikrishnan KP, Weg JG. Tuberculous enteritis and peritonitis. Report of 36 general hospital cases. Arch Intern Med. 1980;140:506–8.
Engin G, Acunas B, Acunas G, Tunaci M. Imaging of extrapulmonary tuberculosis. Radiographics. 2000;20:471–88 (quiz 529-30, 32).
Leder RA, Low VH. Tuberculosis of the abdomen. Radiol Clin North Am. 1995;33:691–705.
Sharma MP, Bhatia V. Abdominal tuberculosis. Indian J Med Res. 2004;120:305–15.
Sheikh M, Moosa I, Hussein FM, Qurttom MA, Behbehani AI. Ultrasonographic diagnosis in abdominal tuberculosis. Australas Radiol. 1999;43:175–9.
Marshall JB. Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol. 1993;88:989–99.
Lied GA, Milde AM, Nylund K, Mujic M, Grimstad T, Hausken T, et al. Increased wall thickness using ultrasonography is associated with inflammation in an animal model of experimental colitis. Clin Exp Gastroenterol. 2012;5:195–201.
Zhu QQ, Zhu WR, Wu JT, Chen WX, Wang SA. Comparative study of intestinal tuberculosis and primary small intestinal lymphoma. World J Gastroenterol. 2014;20:4446–52.
Valette PJ, Rioux M, Pilleul F, Saurin JC, Fouque P, Henry L. Ultrasonography of chronic inflammatory bowel diseases. Eur Radiol. 2001;11:1859–66.
De Franco A, Marzo M, Felice C, Pugliese D, Veronica AD, Bonomo L, et al. Ileal Crohnʼs disease: CEUS determination of activity. Abdom Imaging. 2012;37:359–68.
Almadi MA, Ghosh S, Aljebreen AM. Differentiating intestinal tuberculosis from Crohnʼs disease: a diagnostic challenge. Am J Gastroenterol. 2009;104:1003–12.
Giangregorio F, Bertone A, Fanigliulo L, Comparato G, Aragona G, Marinone MG, Fornari F. Predictive value of time–intensity curves obtained with contrast-enhanced ultrasonography (CEUS) in the follow-up of 30 patients with Crohnʼs disease. J ultrasound. 2009;12(4):151–9.
Migaleddu V, Scanu AM, Quaia E, Rocca PC, Dore MP, Scanu D, et al. Contrast-enhanced ultrasonographic evaluation of inflammatory activity in Crohnʼs disease. Gastroenterology. 2009;137:43–52.
Ardizzone S, Bianchi Porro G. Inflammatory bowel disease: new insights into pathogenesis and treatment. J Intern Med. 2002;252(6):475–96.
Pizarro TT, Pastorelli L, Bamias G, Garg RR, Reuter BK, Mercado JR, et al. SAMP1/YitFc mouse strain: a spontaneous model of Crohnʼs disease-like ileitis. Inflamm Bowel Dis. 2011;17:2566–84.
Rasheed S, Zinicola R, Watson D, Bajwa A, McDonald PJ. Intra-abdominal and gastrointestinal tuberculosis. Colorectal Dis. 2007;9:773–83.
Acknowledgments
We thank all the participants included in the present study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have nothing to declare.
About this article
Cite this article
Yang, G., Zhang, W., Yu, T. et al. The features of intestinal tuberculosis by contrast-enhanced ultrasound. Jpn J Radiol 33, 577–584 (2015). https://doi.org/10.1007/s11604-015-0459-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11604-015-0459-5