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Crohn’s disease activity: quantitative contrast-enhanced ultrasound assessment

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Abstract

Objectives

To determine whether quantitative parameters from contrast-enhanced ultrasound examination (CE-US) of the bowel wall correlate with endoscopic inflammatory activity in Crohn’s disease and to assess its utility in the follow-up of patients on treatment.

Methods

This was a prospective study of 30 patients with Crohn’s disease requiring colonoscopy or flexible sigmoidoscopy. The Crohn’s disease activity index (CDAI), serum C-reactive protein (CRP) and Crohn’s disease endoscopic index of severity (CDEIS) were calculated. CE-US was performed within 7 days of endoscopy using intravenous perflutren lipid microsphere and repeated a median of 45.5 days following treatment. Time–intensity curves of bowel wall enhancement were generated to derive the area under the curve (AUC), time to peak intensity (TTP) and peak intensity (PI).

Results

In separate multivariate regression models, the AUC, TTP and PI showed no significant association with endoscopic activity whilst controlling for CDAI and CRP. However, the reductions in CDAI and CRP following treatment were mirrored by significant reductions in TTP (P = 0.05).

Conclusions

CE-US does not appear to predict for Crohn’s disease endoscopic activity independent of simple parameters such as CDAI and CRP. However, it may be useful in the serial assessment of patients on treatment.

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Acknowledgments

The authors would like to thank Mr Reginald Wong, FIS MBA for his advice on the statistical analysis as well as the gastroenterologists and sonographers at Royal Perth Hospital who kindly contributed to the undertaking of this study.

Conflicts of interest

Lantheus Medical Imaging supported this study through the provision of the Definity (perflutren lipid microsphere) contrast agent for all recruited patients.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Wellington St, Perth, WA, 6000, Australia

    Daniel D. Wong, Marilyn Zelesco, Rose Mason & Richard M. Mendelson

  2. Department of Gastroenterology, Royal Perth Hospital, Perth, WA, Australia

    Geoff M. Forbes & Janina Pawlik

  3. School of Medicine and Pharmacology, University Department of Medicine, The University of Western Australia, Perth, Australia

    Geoff M. Forbes

Authors
  1. Daniel D. Wong
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  2. Geoff M. Forbes
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  3. Marilyn Zelesco
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  4. Rose Mason
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  5. Janina Pawlik
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  6. Richard M. Mendelson
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Corresponding author

Correspondence to Daniel D. Wong.

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Wong, D.D., Forbes, G.M., Zelesco, M. et al. Crohn’s disease activity: quantitative contrast-enhanced ultrasound assessment. Abdom Imaging 37, 369–376 (2012). https://doi.org/10.1007/s00261-011-9792-z

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  • DOI: https://doi.org/10.1007/s00261-011-9792-z

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