Contrast enhanced ultrasound to evaluate Crohn's Disease severity and outcome
The aim of this study was to evaluate if contrast enhanced ultrasound could grade severity and predict the outcome in patients affected by Crohn's Disease.
We studied twenty patients affected by diagnosed Crohn's Disease (10 women, median age 46,7 years, range 29–79). Each patient underwent to a standard B-mode ultrasound exam using a Logiq 9 ultrasound scanner (General Electric Medical Systems, Milwaukee, WI) equipped with a 7,5MHz linear probe right for using ultrasound contrast agents. After measuring the bowel wall thickness we recorded the enhancement of the intestinal wall for 2 minutes placing a standard gate of 6cm long on the examined bowel segment and we injected a 2.5ml bolus of a sulfur hexafluoride-filled microbubble contrast agent (Sonovue, Bracco Spa, Milan, Italia). Then we calculated “time-intensity curves“ by using a dedicated software. The area under the curve was compared with clinical, biochemical and endoscopical exams by the regression linear text.
Time-intensity diagram presented a wider enhancement area in patients with a more serious disease evaluated according to CDAI. Correlation between CDAI and peak enhancement resulted statistically significant (r=0,70, p=<0,001). After a median follow-up period of 10.1 months, six patients with the widest enhancement area underwent to surgical therapy or showed a complication of the disease such as enteric fistula or obstruction.
Contrast enhanced ultrasound with a second generation contrast agent could help to evaluate Crohn's disease severity and outcome.