The Role of Ultrasound Elasticity Imaging in Predicting Ileal Fibrosis in Crohnʼs Disease Patients

Fraquelli, Mirella; Branchi, Federica; Cribiù, Fulvia Milena; Orlando, Stefania; Casazza, Giovanni; Magarotto, Andrea; Massironi, Sara; Botti, F.; Contessini-Avesani, Ettore; Conte, Dario; Basilisco, Guido; Caprioli, Flavio

doi:10.1097/mib.0000000000000536

Cited by 77 publications

(122 citation statements)

References 28 publications

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“…The introduction of dedicated US software for elastographic assessments would greatly improve the diagnostic potential of CEUS for assessing bowel wall fibrosis grade in patients with CD [78][79][80][81].…”

Section: Ceusmentioning

confidence: 99%

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%

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

et al. 2017

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“…They confirmed the usefulness of SE in detecting fibrosis within the bowel wall. Particularly the calculation of ''strain ratio'' (between the affected bowel wall and the adjacent mesentery) was more accurate than the ''visual score'' in differentiating between severe fibrosis, moderate fibrosis and inflammation affecting the bowel wall [12].…”

Section: Discussionmentioning

confidence: 96%

Feasibility of CEUS and strain elastography in one case of ileum Crohn stricture and literature review

et al. 2016

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Contrast-enhanced ultrasonography (CEUS) and strain elastography (SE) are diagnostic imaging methods, which are still not routinely used in the clinical management of inflammatory bowel diseases. However, there are studies in the literature reporting on the use of both CEUS and SE in patients with bowel obstruction due to Crohn's disease, documenting the usefulness of these two methods in the differentiation between inflammation and fibrosis affecting the bowel wall. The aim of this case report is to evaluate the usefulness of CEUS and SE performed in a patient with Crohn's disease, who was admitted to hospital with bowel obstruction due to terminal ileal stricture and submitted to ileocecal resection. CEUS and SE identified and to some extent also characterized the inflammatory and fibrotic processes affecting the bowel wall. Macroscopic and microscopic examinations of the surgical specimen confirmed the presence of inflammatory phenomena (exudates, ulcers, and fistulas) and fibrosis as suggested by ultrasound (US) imaging methods.Sommario L' ecografia con mezzo di contrasto (CEUS) e la elastografia strain (SE) sono metodiche recenti, ancora poco utilizzate nel management clinico delle malattie infiammatorie croniche intestinali. Riguardo alle stenosi intestinali nel morbo di Crohn, in Letteratura sono pubblicati studi sia con la CEUS che con la SE che hanno documentato l'utilità delle due metodiche nel differenziare la natura flogistica o fibrotica del tratto patologico. Scopo di questo report è di valutare l'utilità delle due metodiche in un paziente affetto da morbo di Crohn, ricoverato per occlusione intestinale da stenosi dell'ultima ansa ileale ed operato di resezione dell'ileo terminale e del ceco. La CEUS e la Elastografia Strain hanno permesso la documentazione ed in un certo grado anche una misura dei processi flogistici e fibrotici a carico della parete intestinale affetta. L'esame macroscopico e microscopico del tratto resecato ha consentito di confermare la presenza dei fenomeni flogistici e fibrotici come ipotizzato con le due metodiche ecografiche.

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“…Recent human model research suggests that the affected segments of the intestine have a higher strain than the normal ones both on elastographic, and on direct measurements [98,101,105]. Moreover, comparing the SE results with histologic features, the strain values correlate with the histologic characteristics of fibrosis, such as collagen and muscular fibers deposits [101,102]. The assessment of intestinal fibrosis and the differentiation of inflammation from fibrosis have been studied using a semi quantitative visual color scale and the strain ratio (SR) which is the ratio between the mean strain in the normal intestinal tissue near the lesions and the mean strain of the affected intestinal tissue [106].…”

Section: Elastographymentioning

confidence: 99%

“…The assessment of intestinal fibrosis and the differentiation of inflammation from fibrosis have been studied using a semi quantitative visual color scale and the strain ratio (SR) which is the ratio between the mean strain in the normal intestinal tissue near the lesions and the mean strain of the affected intestinal tissue [106]. SR demonstrated a good ability to diagnose severe intestinal fibrosis, but failed to differentiate the degree of inflammation [102].…”

Section: Elastographymentioning

confidence: 99%

“…Fibrosis develops in time as a consequence of chronic inflammation and has a major influence on IBD morbidity, as it is associated with high rates of hospitalization and surgical interventions [99]. The opportunity to evaluate the proportion of fibrotic and inflammatory tissue is an important step for the non-invasive management of CD, considering that the presence of fibrotic tissue negatively influences the response to biological treatment and results in the need for endoscopic or surgical treatment [99][100][101][102].…”

Section: Elastographymentioning

confidence: 99%

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The importance of intestinal ultrasound and elastographic techniques in inflammatory bowel diseases

Marin

Tribus

Fierbinţeanu-Braticevici

2018

Med Ultrason

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Inflammatory bowel diseases have an important impact upon the economic and social status due to their increasing incidence and prevalence, often affecting young people. At the moment, the therapeutic goal goes beyond the improvement of symptoms and laboratory parameters, being represented by endoscopic mucosal healing, changing the disease’s natural history. Even though endoscopy is the gold standard for the assessment of mucosal healing, it is an invasive maneuver and it lacks good repeatability. These patients require frequent evaluation; therefore, interest for noninvasive techniques has risen.As a consequence, the importance of intestinal ultrasound has increased lately and recent studies support its use to assess the degree of inflammation, to differentiate between remission and relapse, to monitor therapy response and guide treatment, to evaluate prognosis, and to diagnose complications. Another promising noninvasive imagistic technique is elastography which has gained interest because of its capacity to discriminate between inflammatory and fibrotic tissue, taking into account the different therapeutic options for the fibrotic strictures compared to inflammatory processes. This review summarizes the actual recommendations regarding the use of intestinal ultrasound and elastographic techniques for the diagnosis and monitoring of inflammatory bowel diseases.

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The Role of Ultrasound Elasticity Imaging in Predicting Ileal Fibrosis in Crohnʼs Disease Patients

Abstract: UEI can be used to assess ileal fibrosis in CD patients.

Cited by 77 publications

References 28 publications

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

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

Feasibility of CEUS and strain elastography in one case of ileum Crohn stricture and literature review

The importance of intestinal ultrasound and elastographic techniques in inflammatory bowel diseases

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