Vincenzo Antonio Migaleddu MD, Presenter: Nothing to Disclose

Roberto Prost MD, Abstract Co-Author: Nothing to Disclose

Domenico Scanu MD, Abstract Co-Author: Nothing to Disclose

Danilo Sirigu MD, Abstract Co-Author: Nothing to Disclose

Gerolamo Campisi MD, Abstract Co-Author: Nothing to Disclose

Giuseppe Virgilio MD, Abstract Co-Author: Nothing to Disclose

To test accuracy of Ultrasound (US), Color-Doppler US (CDUS) and Contrast-enhanced Ultrasound (CEUS) in the evaluation of inflammatory activity in patients with Crohn’s disease(CD) and to correlate those sonographic approaches findings with inflammatory activity as scored by the Crohn’s disease activity index (CDAI).

With the Institutional Review Board approval and informed consent, we recruited 47 patients (M/F=20/27; age mean ± SD, 38±14 years, range 16-71) with a CDAI >150 (n=30) or <150 (n=17). Clinical status and CDAI were unknown to the radiologists performing the scans. Baseline US, CDUS and CEUS examinations were conducted with high-frequency probes (8-14 and 5-7 MHz) before and after injection of sulfur hexafluoride-filled microbubbles. The diagnostic accuracy of baseline US, CDUS and CEUS were calculated by using the endoscopic and histological findings as reference standards. Moreover, baseline US, CDUS and CEUS scans were reviewed by three observers and correlated with the CDAI by using the Pearson's linear correlation coefficient.

CEUS had the higher performance with 93.5% sensitivity, 93.7 % specificity, 96.6% positive predictive value, 88.2% negative predictive value, and 93.6 % overall accuracy. CEUS revealed three bowel wall perfusion patterns after microbubble injection: submucosal enhancement, inward and outward transparietal enhancement .CEUS v/s CDAI yielded Pearson’s linear correlation coefficient of 0.74 (p-value<0.0001); baseline US (thickness, length, multilayer appearance of bowel involved) v/s CDAI were respectively of 0.68 (p-value<0.0001), of 0.47 (p-value=0.0009) and of 0.60 (p-value<0.0001); CDUS v/s CDAI 0.73 (p-value <0.0001).

CEUS showed very high performance for evaluating Crohn's disease activity.

To verify the accuracy of Ultrasound, Color-Doppler US  and Contrast-enhanced Ultrasound  in the evaluation of inflammatory activity in patients with Crohn’s disease.

Migaleddu, V, Prost, R, Scanu, D, Sirigu, D, Campisi, G, Virgilio, G, Ultrasonographic Evaluation of Inflammatory Activity in Crohns Disease: Importance of Contrast Enhancement.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8015759.html