Ileal Crohn disease: mural microvascularity quantified with contrast-enhanced US correlates with disease activity
| Autor: | Alessandra Di Veronica, Lorenzo Bonomo, Alessandro Armuzzi, Francesco Danza, Italo De Vitis, A Franco, E. Bock, Alfredo Papa, I. Roberto, Barbara De Pascalis, Manuela Marzo, Luisa Guidi |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Adolescent Aged Contrast Media Crohn Disease Female Humans Ileitis Microvessels Middle Aged Reproducibility of Results Sensitivity and Specificity Statistics as Topic Ultrasonography Young Adult Phospholipids Sulfur Hexafluoride Settore MED/12 - GASTROENTEROLOGIA contrast-enhanced US ileal Disease activity Medicine Radiology Nuclear Medicine and imaging In patient Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA business.industry Crohn disease microvascularity Settore MED/09 - MEDICINA INTERNA digestive oral and skin physiology medicine.disease digestive system diseases chron business Bowel wall |
| Popis: | To quantitatively assess microvascular activation in the thickened ileal walls of patients with Crohn disease (CD) by using contrast-enhanced ultrasonography (US) and evaluate its correlation with widely used indexes of CD activity.This prospective study was approved by the ethics committee, and written informed consent was obtained from all patients. The authors examined 54 consecutively enrolled patients (mean age, 35.29 years; age range, 18-69 years; 39 men, 15 women) with endoscopically confirmed CD of the terminal ileum. Ileal wall segments thicker than 3 mm were examined with low-mechanical-index contrast-enhanced US and a second-generation US contrast agent. The authors analyzed software-plotted time-enhancement intensity curves to determine the maximum peak intensity (MPI) and wash-in slope coefficient (β) and evaluated their correlation with (a) the composite index of CD activity (CICDA), (b) the CD activity index (CDAI), and (c) the simplified endoscopic score for CD (SES-CD, evaluated in 37 patients) for the terminal ileum. Statistical analysis was performed with the Mann-Whitney test, Spearman rank test, and receiver operating characteristic (ROC) analysis.MPI and β coefficients were significantly increased in the 36 patients with a CICDA indicative of active disease (P.0001 for both), the 33 patients with a CDAI of at least 150 (P.032 and P.0074, respectively), and the 26 patients with an SES-CD of at least 1 (P.0001 and P.002, respectively). ROC analysis revealed accurate identification (compared with CICDA) of active CD with an MPI threshold of 24 video intensity (VI) (sensitivity, 97%; specificity, 83%) and a β coefficient of 4.5 VI/sec (sensitivity, 86%; specificity, 83%).Contrast-enhanced US of the ileal wall is a promising method for objective, reproducible assessment of disease activity in patients with ileal CD. |
| Databáze: | OpenAIRE |
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