Contrast-Enhanced Ultrasonographic Evaluation of Inflammatory Activity in Crohn's Disease

Migaleddu, Vincenzo; Scanu, Antonio Mario; Quaia, Emilio; Cossu-Rocca, Paolo; Dore, Maria Pina; Scanu, Domenico; Azzali, Lorenza; Virgilio, Giuseppe

doi:10.1053/j.gastro.2009.03.062

Cited by 181 publications

(136 citation statements)

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“…CEUS showed the highest performance, with 93.5% sensitivity, 93.7% specificity, and 93.6% overall accuracy. The linear correlation coefficient for CEUS versus CDAI was 0.74 (p \ 0.0001) [21]. Moreover, CEUS could be useful to differentiate between fibrotic or inflamed stenosis in CD patients, although this question is controversial: according to some authors, increased echogenicity of the submucosal layer of the bowel wall results in inflammation [21], while others report a clear visibility of all intestinal layers, suggesting fibrosis [62].…”

Section: Ceusmentioning

confidence: 99%

“…Today, bowel US is currently accepted as a clinically important first-line imaging technique in both patients with suspected CD and in follow-up patients known to have CD [13][14][15][16][17][18][19]. Furthermore, the introduction of oral contrast has improved the image quality, overall sensitivity and diagnostic accuracy in the detection of small bowel lesions in CD patients [20], and thus contrast-enhanced ultrasound (CEUS) has become an important imaging modality in patients with CD for grading of disease activity, differentiation between small bowel stricture due to inflammation or mural fibrosis, and the assessment of the response to specific therapy [21,22].…”

Section: Introductionmentioning

confidence: 99%

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SICUS and CEUS imaging in Crohn’s disease: an update

et al. 2017

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Endoscopy remains the main technique in the diagnosis and treatment of Crohn's disease (CD); nevertheless, the recent development of innovative and non-invasive imaging techniques has led to a new tool in the exploration of small bowel in CD patients. This paper reviews the available data on ultrasound imaging used for the evaluation of CD, highlighting the role of small intestine contrast-enhanced ultrasonography with the use of oral and intravenous contrast agents.Keywords Crohn's disease Á Contrast-enhanced ultrasound Á Small intestine contrast ultrasonography Sommario Nell'iter diagnostico e terapeutico della malattia di Crohn l'endoscopia rappresenta la principale metodica strumentale. Tuttavia, la recente introduzione di tecniche di imaging innovative e non invasive ha implementato lo studio dell'intestino nelle malattie infiammatorie croniche intestinali. La seguente revisione raccoglie i dati disponibili in letteratura relativi all'utilizzo dell'ecografia con mezzo di contrasto, sia orale (SICUS) sia endovenoso (CEUS), nella valutazione dei pazienti affetti da malattia di Crohn.

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Section: Ceusmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

SICUS and CEUS imaging in Crohn’s disease: an update

et al. 2017

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“…Migaleddu et al [30] observed three different types of enhanced perfusion pattern of the diseased intestinal wall: a submucosal prevalent enhancement pattern, a transparietal enhancement starting from the submucosa and a transparietal enhancement pattern starting from extra-visceral vessels and secondary involving the wall of the intestinal loop with an external to internal direction. These patterns are related to the activity of CD as assessed by the CDAI index.…”

Section: Ultrasonographic Features Of the Intestinal Wall In Crohn's mentioning

confidence: 99%

“…Thus, CEUS is especially indicated for evaluating inflammatory activity in CD. Patients with active CD and with a thickened enhancing small bowel wall after contrast agent injection have a higher probability of positively responding to medical treatment than patients with active CD and low or absent enhancement, while patients with quiescent CD but thickened enhancing intestinal wall have a higher risk or recurrence [30]. Moreover, CEUS can characterize bowel wall thickening by differentiating fibrosis, edema and inflammatory neovascularisation.…”

Section: Ultrasonographic Features Of the Intestinal Wall In Crohn's mentioning

confidence: 99%

Ultrasonographic findings in Crohn’s disease

2014

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In recent years transabdominal bowel sonography has become a first-line modality both in the diagnosis and in the follow-up of inflammatory bowel diseases, especially Crohn's disease, reaching values of sensitivity ranging from 84 to 93 %. In particular, its role is very useful in the early diagnosis of complications such as stenosis, phlegmons, abscesses and fistulae. According to the available literature the ability of US to provide information about disease activity is still under debate and further studies are necessary. In this regard, of fundamental importance is the use of additional techniques such as color-and power-Doppler and contrast-enhanced ultrasound. The purpose of this paper is to report the main sonographic intestinal and extraintestinal findings detectable in Crohn's disease.Keywords Transabdominal bowel sonography Á Crohn's disease Á Color and power Doppler Á CEUS Á Disease activity Riassunto Nel corso degli ultimi anni l'ecografia delle anse intestinali è andata affermandosi come metodica di prima linea nella diagnosi e nel follow-up delle malattie infiammatorie croniche intestinali, soprattutto nella malattia di Crohn, con valori di accuratezza diagnostica dell'84-93 %. In particolare il suo ruolo risulta preminente nella precoce diagnosi delle complicanze, quali stenosi, flemmoni, ascessi e fistole. In accordo con la letteratura disponibile più discussa rimane la capacità di fornire informazioni circa l'attività di malattia ed ulteriori studi appaiono necessari. A tal proposito è fondamentale l'utilizzo di metodiche quali color e power Doppler e l'ecografia con mezzo di contrasto (CEUS). Scopo del presente lavoro è quello di riportare i principali quadri ecografici intestinali ed extra-intestinali evidenziabili nella malattia di Crohn.

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“…For instance, patients with no enhancement can be separated from those with enhancement or the patients can be categorized according to where in the GI-wall the enhancement is detectable [42,43,55,56]. The operators' interpretation and the sensitivity of the US equipment may, however, affect the results [57].…”

Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%

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2017

Ultraschall in Med

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Contrast-Enhanced Ultrasonographic Evaluation of Inflammatory Activity in Crohn's Disease

Cited by 181 publications

References 45 publications

SICUS and CEUS imaging in Crohn’s disease: an update

SICUS and CEUS imaging in Crohn’s disease: an update

Ultrasonographic findings in Crohn’s disease

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