Research

Modern Ultrasound Evaluation of Inflammatory Activity in Crohn's Disease


Abstract of oral presentation by SMIRG at the 92nd congress of Radiological Society of North America (RSNA 2006)

V Migaleddu, MD, Sassari, Sardinia ITALY; R Prost, MD; G Virgilio, MD; G Campisi, MD; D Scanu, MD

PURPOSE

To correlate ultrasound (US), Color Doppler Imaging (CDI), Contrast Enhancement Ultrasound (CEUS)findings and inflammatory activity in Crohn’s Disease (CDAI).

METHOD AND MATERIALS

30 patients were included in the trial (F 15, aged 16-71) with a diagnosis of Crohn’s Disease (22 with CDAI>150 and 8<150). The ultrasonographers had no knowledge of clinical details and inflammatory index. The US and CDI exams were performed with a Sequoia 512 (Siemens) high frequency probe (10-14 MHz); the CEUS exam with a high frequency Esatune (Esaote) probe and contrast medium (2.4 ml SonoVue i.v.). Sensitivity, specificity, VPP, VPM, global accuracy for US, CDI and CEUS, were calculated with respect to clinical, radiological, endoscopic and histological findings. Scores for the US, CDI and CEUS picture were evaluated and correlated with the CDAI by Spearman rank test (p>0.0005).

RESULTS

Ultrasonography (US, CDI, CEUS) was able to identify 21 VP, 1 FP, 8 VN and 0 FN in evaluating disease activity (sensitivity 95%, specificity 100%, VPP 100%, VPN 89%, diagnostic accuracy 97%). Significant correlation between the US, CDI, CEUS and the CDAI findings was present (p>0.00001). The CEUS showed 3 perfusion pictures of activity: submucous enhancement, transparietal submucous enhancement, and transparietal from extra-visceral vessels enhancement.

CONCLUSION

The use of an ultrasound contrast medium with high frequency probes is helpful in evaluating inflammatory activity of the intestine in Crohn’s Disease.

CLINICAL RELEVANCE/APPLICATION

The evaluation of inflammatory activity in Crohn's disease is necessary to plan terapeutic programs. Contrast enhanced ultrasound and conventional ultrasonographic approaches can help this evaluation.