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Contrast-enhanced ultrasonography with Sonazoid™ for the evaluation of bowel ischemia
Tomoko Kanzaki1, Jiro Hata2, Hiroshi Imamura2
1Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. ttokkok7@hotmail.com.
Insights
Contrast-enhanced ultrasonography using Sonazoid™ is a highly effective tool for diagnosing bowel ischemia. This method demonstrates excellent sensitivity and specificity, making it reliable for identifying this critical condition.
Area of Science:
- Medical Imaging
- Gastroenterology
- Diagnostic Techniques
Background:
- Bowel ischemia is a critical condition requiring prompt diagnosis.
- Accurate detection of bowel ischemia is essential for timely intervention and improved patient outcomes.
Purpose of the Study:
- To evaluate the diagnostic utility of contrast-enhanced ultrasonography (CEUS) with Sonazoid™ for detecting bowel ischemia.
- To assess the sensitivity and specificity of CEUS in identifying bowel ischemia.
Main Methods:
- Sixty-five patients with suspected bowel ischemia were enrolled.
- Sonazoid™ was administered, and bowel segments were scanned using harmonic imaging.
- Signal intensities were classified as normal or diminished, with diagnoses confirmed by surgery, autopsy, endoscopy, angiography, or clinical follow-up.
Main Results:
- CEUS demonstrated 100% sensitivity and 98% specificity for detecting bowel ischemia.
- A negative predictive value of 100% indicates that normal signal intensity reliably rules out ischemia.
- Diminished signal intensity correctly identified ischemia in 93% of cases.
Conclusions:
- Contrast-enhanced ultrasonography with Sonazoid™ is a highly sensitive and specific diagnostic method for bowel ischemia.
- CEUS offers a reliable, non-invasive approach for diagnosing bowel ischemia.
- The technique provides high accuracy in identifying patients with and without bowel ischemia.
Purpose:
To determine the usefulness of contrast-enhanced ultrasonography with the contrast agent Sonazoid™ for the detection of bowel ischemia.
Methods:
From March 2007 to February 2009, 65 patients (35 men and 30 women, mean age 70.4 ± 16.1 years) were enrolled. Fifty-three patients complained of acute abdominal pain with small bowel dilatation (n = 40) or reduced bowel peristalsis (n = 13). Twelve patients were clinically suspected of having bowel ischemia. After Sonazoid™ injection, bowel segments were scanned using harmonic imaging, and the signal intensities were classified as normal or diminished. The definitive diagnosis was confirmed by surgery in 30 patients, autopsy in 6, endoscopy in 3, angiography in 1, and clinical follow-up in 25.
Results:
All 50 patients with normal signal intensities were confirmed not to have bowel ischemia. In the 15 patients with diminished signal intensities, 14 patients were confirmed to have bowel ischemia, resulting in an overall sensitivity of 100% [95% confidence interval (CI) 80.7-100%], a specificity of 98% [95% CI 89.5-99.9%], a positive predictive value of 93% (95% CI 68.1-99.8%), and a negative predictive value of 100% (95% CI 94.1-100%).
Conclusion:
Contrast-enhanced ultrasonography with Sonazoid™ is a highly sensitive and specific method for the diagnosis of bowel ischemia.
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