Bowel Ultrasound State of the Art: Grayscale and Doppler Ultrasound, Contrast Enhancement, and Elastography in Crohn Disease

Lu, Cathy; Merrill, Christina; Medellin, Alexandra; Novak, Kerri L.; Wilson, Stephanie R.

doi:10.1002/jum.14920

Cited by 56 publications

(41 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Identifying mature abscesses: The injection of bacteria and dextran initially resulted in the development of a phlegmon that then evolved into an organized mature abscess over 2-4 weeks. B-mode ultrasound allowed us to identify key structural characteristics, namely a well-defined hypoechoic capsule surrounding a core with mixed echogenic material, which were used as an indicator of maturity (Lu, et al 2019). Doppler imaging was used to further evaluate abscess maturity, with mature abscesses having rich vasculature within the hypoechoic capsule, and an avascular core.…”

Section: Discussionmentioning

confidence: 99%

Treating Porcine Abscesses With Histotripsy: A Pilot Study

Matula

Wang

Khokhlova

et al. 2020

Preprint

View full text Add to dashboard Cite

Infected abscesses are walled-off collections of pus and bacteria. They are a common sequela of complications in the setting of surgery, trauma, systemic infections, and other disease states. Current treatment is typically limited to antibiotics with long-term catheter drainage, or surgical wash-out when inaccessible to percutaneous drainage or unresponsive to initial care efforts. Antibiotic resistance is also a growing concern. Although bacteria can develop drug resistance, they remain susceptible to thermal and mechanical damage. In particular, short pulses of focused ultrasound (i.e., histotripsy) generate mechanical damage through localized cavitation, representing a potential new paradigm for treating abscesses non-invasively, without the need for long-term catheterization and antibiotics. In this pilot study, boiling and cavitation histotripsy treatments were applied to subcutaneous and intramuscular abscesses developed in a novel porcine model. Ultrasound imaging was used to evaluate abscess maturity, for treatment monitoring and assessment of post-treatment outcomes. Disinfection was quantified by counting bacteria colonies from samples aspirated before and after treatment. Histopathological evaluation of the abscesses was performed to identify changes resulting from histotripsy treatment and potential collateral damage. Cavitation histotripsy was more successful in reducing the bacterial load while having a smaller treatment volume compared with boiling histotripsy. The results of this pilot study suggest focused ultrasound may lead to a technology for in situ treatment of acoustically accessible abscesses.

show abstract

Section: Discussionmentioning

confidence: 99%

Treating Porcine Abscesses With Histotripsy: A Pilot Study

Matula

Wang

Khokhlova

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In our animal model, the injection of bacteria and dextran initially resulted in the development of a phlegmon that then evolved into an organized mature abscess over 2-4 weeks. B-mode ultrasound allowed us to identify key structural characteristics, namely a well-defined hypoechoic capsule surrounding a core with mixed echogenic material, which were used as an indicator of maturity (Lu et al 2019). Doppler imaging was used to further evaluate abscess maturity, with mature abscesses having rich vasculature within the hypoechoic capsule, and an avascular core.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Analysis of Abscess Maturation in a Porcine Model

Leotta

Bruce

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

Abscesses are walled-off collections of infected fluids that often develop as complications in the setting of surgery and trauma. Abscess care depends on size, location, composition and complexity, among other patient factors. The goal of this work is to describe, using the latest ultrasound imaging technologies, the progression of abscess development in a porcine animal model. Intramuscular or subcutaneous injections of bacteria plus dextran particles as an irritant led to identifiable abscesses over a 2- to 3-week period. The abscesses were imaged at least weekly with B-mode, 3D B-mode, shear-wave elastography (SWE) and color flow imaging. Mature abscesses were characterized by a well-defined core of varying echogenicity surrounded by a hypoechoic capsule that was highly vascularized on Doppler imaging. Size and shape changes during development were quantified with 3D imaging. With SWE, the lesion stiffness varied interiorly and generally decreased over time. These ultrasound features potentially provide biomarkers to facilitate improved selection of treatment strategies for abscesses.

show abstract

“…Magnetic resonance imaging (MRI) produces three-dimensional anatomical images of patients. In imaging the GI tract, especially for small bowel analysis, MR enterography (MRE), MR enteroclysis, and MR fistulography are the commonly used procedures [99,149]. For both the small and large bowel, intra and extra mural involvement can be measured with the appropriate contrast agents such as barium suspensions [99,150].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…MRI techniques do not use ionizing radiation to acquire images, making them favorable over CT modalities, especially for young patients. Additionally, MRI produces high resolution images while permitting significantly improved soft tissue contrast as compared to CT [149].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Imaging Inflammation and Infection in the Gastrointestinal Tract

Frickenstein

Jones

Behkam

et al. 2019

IJMS

View full text Add to dashboard Cite

A variety of seemingly non-specific symptoms manifest within the gastrointestinal (GI) tract, particularly in the colon, in response to inflammation, infection, or a combination thereof. Differentiation between symptom sources can often be achieved using various radiologic studies. Although it is not possible to provide a comprehensive survey of imaging gastrointestinal GI tract infections in a single article, the purpose of this review is to survey several topics on imaging of GI tract inflammation and infections. The review discusses such modalities as computed tomography, positron emission tomography, ultrasound, endoscopy, and magnetic resonance imaging while looking at up-an-coming technologies that could improve diagnoses and patient comfort. The discussion is accomplished through examining a combination of organ-based and organism-based approaches, with accompanying selected case examples. Specific focus is placed on the bacterial infections caused by Shigella spp., Escherichia coli, Clostridium difficile, Salmonella, and inflammatory conditions of diverticulitis and irritable bowel disease. These infectious and inflammatory diseases and their detection via molecular imaging will be compared including the appropriate differential diagnostic considerations.

show abstract

Bowel Ultrasound State of the Art: Grayscale and Doppler Ultrasound, Contrast Enhancement, and Elastography in Crohn Disease

Cited by 56 publications

References 55 publications

Treating Porcine Abscesses With Histotripsy: A Pilot Study

Treating Porcine Abscesses With Histotripsy: A Pilot Study

Sonographic Analysis of Abscess Maturation in a Porcine Model

Imaging Inflammation and Infection in the Gastrointestinal Tract

Contact Info

Product

Resources

About