Ernst Michael Jung MD, Presenter: Nothing to Disclose

Christina Gierlich MD, PhD, Abstract Co-Author: Nothing to Disclose

Dirk-Andre Clevert MD, Abstract Co-Author: Nothing to Disclose

Stefan G.E. Feuerbach MD, Abstract Co-Author: Nothing to Disclose

Doris Schacherer MD, PhD, Abstract Co-Author: Nothing to Disclose

Andreas G. Schreyer MD, Abstract Co-Author: Nothing to Disclose

Patients with inflammatory bowel disease (IBD) often undergo several radiologic imaging studies, which - with the exception of MRI and US - subject patients to ionizing radiation. With contrast enhanced ultrasound microvascular imaging of the bowel is possible. Hence, the aim of our study was to assess the perfusion pattern of inflamed bowel walls in Crohn`s disease compared with healthy volunteers quantitatively using a specific quantification software.

We evaluated 4 volunteers and 20 patients with proven Crohn`s disease , who went through an active episode based on clinical symptoms and complementary imaging by MRI (19 patients) and computed tomography (1 patient), respectively, with dynamic contrast-enhanced ultrasound (CEUS) using a second generation contrast agent (SonoVue®, Bracco, Italy). Retrospectively, we applied the quantification software Qontrast® (Bracco, Milan, Italy) to obtain contrast-enhanced sonographic perfusion maps for each lesion.

Patients had significant higher peak values (median 46.86, 25th 37.91, 75th 53.20) and significant higher regional blood volume (median 2133.65, 25th 1202.90, 75th 2820.44) than volunteers. Considering the very low peak value of the healthy, it`s easy to understand, that the time-to-peak is significantly shorter in the volunteers (median 4.45, 25th 1.82, 75th 6.88) than in the patients (median 12.15, 25th 9.18, 75th 15.74). Our study showed clear differences between inflamed and normal bowel wall vascularity regarding all perfusion parameters.   

These results show that a quantitative assessment of the bowel wall vascularisation and inflammation, respectively, is possible. The software used here enables us to collect data, not only in a semiquantitative but also in a reproducible, quantitative manner, which is comparable with the evaluation of CT or MRI generated data.   

New ultrasound method for quantitative measurement of inflammatory mural contrast enhancement

Jung, E, Gierlich, C, Clevert, D, Feuerbach, S, Schacherer, D, Schreyer, A, Quantitative Assessment of Bowel Wall Vascularization in Crohns Disease with Contrast-enhanced Ultrasound and Perfusion Analysis.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8004550.html