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Published on: October 20, 2013
Crohn's disease activity: quantitative contrast-enhanced ultrasound assessment
Daniel D Wong1, Geoff M Forbes, Marilyn Zelesco
1Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, WA, Australia. ddwong@optusnet.com.au
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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