Ileal Crohn’s disease: CEUS determination of activity

Abstract

Transabdominal ultrasound is currently accepted as a clinical first-line tool in the assessment of Crohn's disease activity. During recent years, great improvements have been achieved in ultrasound examination with the introduction of high-frequency transducers, ultrasonographic microbubble contrast agents, and dedicated contrast-specific ultrasound software. Therefore, contrast-enhanced ultrasonography (CEUS) is emerging as one of the most important imaging techniques in the diagnosis and follow-up of patients with ileal Crohn's disease. It is non-invasive and non-ionizing, easily repeatable, well-tolerated by patients and has significant diagnostic accuracy. Moreover, the possibility to monitor response to therapies, describing, and quantifying contrast enhancement behavior by specific software, represents an interesting aspect of its utilization, considering the still open questions about the correct use of immunosuppressive and biological agents. The aim of our review is to provide an updated overview of the role of CEUS in the patients who have an ileal localization of Crohn's disease, defining its qualitative and quantitative features.

The features of intestinal tuberculosis by contrast-enhanced ultrasound

“…For intestinal TB, the bowel wall thickening was more obvious and the lesions usually spread across the entire bowel wall layers. Crohn's disease showed a high degree of enhancement in all layers of bowel wall or the inner bowel wall layer in the active stage of CEUS, while only mucosa enhancement or no enhancement was observed in the remission stage [25]. In the present study, all layers of the bowel wall were enhanced during CEUS.…”

Measuring disease activity in Crohn's disease: what is currently available to the clinician

“…Doppler US and contrast-enhanced US may feasibly help emphasize the vascularization pattern and thus increase the method’s diagnostic accuracy in identifying CD activity, but they have demonstrated a similar sensitivity and specificity to conventional US 48. On the other hand, contrast-enhanced US was able to classify the severity identified at endoscopy significantly better than Doppler US 49,50. Calabrese et al developed a quantitative index for assessing CD-related small bowel damage as detected by small intestine contrast ultrasonography, called the sonographic lesion index for CD (SLIC) 51.…”

Monitoring Disease Activity and Progression in Crohn's Disease. A Swiss Perspective on the IBD Ahead ‘Optimised Monitoring' Recommendations

“…Contrast-enhanced ultrasound (CEUS) and small intestine contrast ultrasound (SICUS) play a limited role in baseline assessment due to lack of standardisation and poor accessibility [93,94,95,96]. …”