Tomas Ripolles MD, Abstract Co-Author: Nothing to Disclose

Maria Jesus Martinez Perez, Abstract Co-Author: Nothing to Disclose

Paula Bartumeus, Presenter: Nothing to Disclose

Cristina Ramirez, Abstract Co-Author: Nothing to Disclose

Jose María Paredes, Abstract Co-Author: Nothing to Disclose

To evaluate the sonographic changes secondaries to anti-TNF therapy in patients with CD and its relationship with to the patient’s short-term outcome.

24 patients with confirmed CD were prospectively examined with sonography the day of the beginning of treatment and about 10 weeks later. Sonographic exam included evaluation of bowel wall thickness, vascularity pattern and perienteric changes. The sonographic findings were compared with clinical (CDAI) and laboratory data (CRP). Evaluation of the response of the anti-TNF therapy was taken 10 weeks later, and patients were classified in three categories: no response, partial response (decrease in CDAI 70 and abnormal CRP) and remission (CDAI 150 and normal CRP)

Median values of bowel wall thickness in the initial sonography was 6,27  1,38 mm (range: 3,5-10 mm), 17 patients (71%) had moderate or marked parietal vascularity, and transmural complications were present in 8 patients (33%). After 10 weeks of anti-TNF treatment 8 patients achieved clinical remission, 6 patients had partial response and 10 patients had no response. A statistically significant reduction of bowel wall thickness (median: 5,31 mm; p=0,007) and in the color grades of the affected bowel (p=0,002) after treatment was also observed. A reduction of bowel wall thickness was seen in 12 of 16 (75%) patients with partial response or remission, whereas in any of the 8 patients with absence of response there was a decrease of the bowel wall thickness (p=0,001). Color Doppler grading decreased only in patients with partial response or remission (10 of 16), and it did not change in group of patients with non response (p=0,004). Transmural complications disappeared in all patients with response to treatment and persisted in non response patients (p=0,005).

ultrasound seems to be a promising noninvasive method in the evaluation of response to treatment with anti-TNF agents in patients with CD

Other studies have evaluated imaging techniques in perianal fistulae as a predictor for short and long term response to treatment. However, no paper has been published evaluating the response to anti-TNF treatment in intrabdominal disease

Ripolles, T, Martinez Perez, M, Bartumeus, P, Ramirez, C, Paredes, J, Evaluation of the Response of the Anti-TNF (Tumor Necrosis Factor) Treatment in Crohn´s Disease by Ultrasound.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5005689.html