The vascularity of internal fistulae in Crohn's disease: an in vivo power Doppler ultrasonography assessment

Maconi, Giovanni; Sampietro, Gianluca; Russo, Antonio; Bollani, S.; Cristaldi, M.; Parente, F.; Dottorini, F.; Porro, G. Bianchi

doi:10.1136/gut.50.4.496

Cited by 56 publications

(30 citation statements)

References 25 publications

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“…Increased microvascular density in CD and UC has been shown clinically, and our work corroborates this through PECAM-1/CD31 staining of the microvasculature in CD specimens where vessel density is significantly increased in the mucosal and submucosal tissue layers with a total increase in vascular density being similar to that observed in experimental colitis (Fig. 2) (31,58,92,143). Interestingly, microvascular dysfunction during IBD shows a temporal relationship with tissue pathology based on observed microscopic alterations in tissue morphology (95).…”

Section: Ibd Pathogenesissupporting

confidence: 73%

Pathogenic angiogenesis in IBD and experimental colitis: new ideas and therapeutic avenues

Chidlow

Shukla²,

Grisham³

et al. 2007

American Journal of Physiology-Gastrointestinal and Liver Physi

143

114

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Chidlow JH Jr, Shukla D, Grisham MB, Kevil CG. Pathogenic angiogenesis in IBD and experimental colitis: new ideas and therapeutic avenues. Am J Physiol Gastrointest Liver Physiol 293: G5-G18, 2007. First published April 26, 2007; doi:10.1152/ajpgi.00107.2007.-Angiogenesis is now understood to play a major role in the pathology of chronic inflammatory diseases and is indicated to exacerbate disease pathology. Recent evidence shows that angiogenesis is crucial during inflammatory bowel disease (IBD) and in experimental models of colitis. Examination of the relationship between angiogenesis and inflammation in experimental colitis shows that initiating factors for these responses simultaneously increase as disease progresses and correlate in magnitude. Recent studies show that inhibition of the inflammatory response attenuates angiogenesis to a similar degree and, importantly, that inhibition of angiogenesis does the same to inflammation. Recent data provide evidence that differential regulation of the angiogenic mediators involved in IBD-associated chronic inflammation is the root of this pathological angiogenesis. Many factors are involved in this phenomenon, including growth factors/cytokines, chemokines, adhesion molecules, integrins, matrix-associated molecules, and signaling targets. These factors are produced by various vascular, inflammatory, and immune cell types that are involved in IBD pathology. Moreover, recent studies provide evidence that antiangiogenic therapy is a novel and effective approach for IBD treatment. Here we review the role of pathological angiogenesis during IBD and experimental colitis and discuss the therapeutic avenues this recent knowledge has revealed. inflammation; T cells; growth factors; adhesion molecules; antiangiogenesis ANGIOGENESIS PLAYS AN IMPORTANT role in many chronic inflammatory diseases including but not limited to diabetic retinopathy, atherosclerosis, rheumatoid arthritis, hypercholesterolemia, and psoriasis. It has been suggested that the angiogenic components of these diseases contribute to and exacerbate disease conditions (26, 31). Recent findings, both clinical and experimental, indicate that angiogenesis also plays a crucial role in the inflammatory bowel diseases (IBD), consisting of Crohn's disease (CD) and ulcerative colitis (UC) (31,37,58,131,155). Development of new vasculature during chronic inflammation may play a negative "pathological" role by contributing to increased inflammatory responses due to dysfunctional new vessel architecture and increases in the recruitment of inflammatory cell types. Importantly, recent data have shown that angiogenic inhibition during chronic inflammatory diseases attenuates further inflammation and disease pathology (31, 37, 51). As such, expanding our knowledge of how pathological angiogenesis occurs during IBD will further our ability to treat patients with these diseases. IBD PathogenesisCD and UC are idiopathic inflammatory disorders of the intestine and/or colon in which patients suffer from rectal bleeding, severe...

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Section: Ibd Pathogenesissupporting

confidence: 73%

Pathogenic angiogenesis in IBD and experimental colitis: new ideas and therapeutic avenues

Chidlow

Shukla²,

Grisham³

et al. 2007

American Journal of Physiology-Gastrointestinal and Liver Physi

143

114

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“…At gray-scale US, these penetrating tracts appear as linear areas of altered echogenicity (most often hypoechoic, although they may contain echogenic gas or debris) arising from the serosal surface of the intestine (Fig 15) (29). At color or power Doppler US, increased signal intensity in the wall of penetrating tracts has also been described (30). Affected bowel loops may appear tethered or angulated.…”

Section: Sinus Tracts and Fistulasmentioning

confidence: 99%

Pediatric Small Bowel Crohn Disease: Correlation of US and MR Enterography

Dillman¹,

Smith

Sanchez³

et al. 2015

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Small bowel Crohn disease is commonly diagnosed during the pediatric period, and recent investigations show that its incidence is increasing in this age group. Diagnosis and follow-up of this condition are commonly based on a combination of patient history and physical examination, disease activity surveys, laboratory assessment, and endoscopy with biopsy, but imaging also plays a central role. Ultrasonography (US) is an underutilized well-tolerated imaging modality for screening and follow-up of small bowel Crohn disease in children and adolescents. US has numerous advantages over computed tomographic (CT) enterography and magnetic resonance (MR) enterography, including low cost and no required use of oral or intravenous contrast material. US also has the potential to provide images with higher spatial resolution than those obtained at CT enterography and MR enterography, allows faster examination than does MR enterography, does not involve ionizing radiation, and does not require sedation or general anesthesia. US accurately depicts small bowel and mesenteric changes related to pediatric Crohn disease, and US findings show a high correlation with MR imaging findings in this patient population.

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“…9) or between intestinal loops and other structures, commonly subdivided into perineal, external and internal [33,36,37].…”

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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The vascularity of internal fistulae in Crohn's disease: an in vivo power Doppler ultrasonography assessment

Cited by 56 publications

References 25 publications

Pathogenic angiogenesis in IBD and experimental colitis: new ideas and therapeutic avenues

Pathogenic angiogenesis in IBD and experimental colitis: new ideas and therapeutic avenues

Pediatric Small Bowel Crohn Disease: Correlation of US and MR Enterography

Ultrasonographic findings in Crohn’s disease

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