Innovations in contrast enhanced high resolution ultrasound improve sonographic imaging of the intestine

The aim was to describe the perfusion pattern of the inflamed bowel wall and the surrounding tissue in inflammatory bowel disease and diverticulitis of the sigmoid colon applying a high resolution matrix transducer and the new hybrid technique. We performed contrast enhanced ultrasound (CEUS) using an updated version of the 1-5 MHz (C1-5-D convex probe) and the 6-9 MHz probe (9L-D linear probe) as well as a matrix 6-15 MHz transducer (ML 6-15-D Matrix Array Linear Probe) and updated post-processing procedures to examine microvascularization of inflamed bowel wall in Crohn's disease (11 patients), ulcerative colitis (1 patient) and diverticulitis of the sigmoid colon (2 patients). Assessment of mural microvascularization was successful as well as identification of fistulas (2 patients) and covered perforation (1 patient). Moreover analysis of time intensity curves revealed increase of signal intensity up to 20 dB. Summarizing, application of high resolution linear probes and use of updated post-processing methods substantially improve detection of inflammation-caused increased microcirculation of the bowel wall and the surrounding tissue as well as identification of complications as fistulas or covered perforations.