Antonio DeFranco MD, Abstract Co-Author: Nothing to Disclose

Alessandra Di Veronica, Presenter: Nothing to Disclose

Luisa Guidi, Abstract Co-Author: Nothing to Disclose

Italo De Vitis, Abstract Co-Author: Nothing to Disclose

Enrico Bock MD, Abstract Co-Author: Nothing to Disclose

Lorenzo Bonomo MD, Abstract Co-Author: Nothing to Disclose

Evaluate patients with ileal Crohn’s Disease (CD) using CEUS with blood pool contrast agent (sulphur hexafluoride, SonoVue® - SV-Bracco Italy) and HDI-QLab software elaboration and correlate quantitative data obtained with the Simple Endoscopic Score for Crohn’s Disease (SES-CD).

After informed consent, between 2006 and 2007, thirthy seven consecutive patients (M25, F12, age range 18-69 years; mean age 31) affected by ileal CD without colon-rectal disease or with inactive colonic disease, were studied by CEUS. Thirthy seven US examinations with second generation contrast agent (SonoVue® i.v. 4,8 ml) were performed. According to the Montreal classification 11 patients had inflammatory, 10 stricturing and 16 penetrating disease. All patients underwent ileoscopy and were scored from 0 to 3 using selected endoscopic parameters (ulcer size, ulcerated and affected surfaces, stenosis) in conformity to SES-CD as suggested by Daperno-Rutgeerts. Maximum peak intensity (MPI) and coefficient of the wash-in slope (β), obtained by HDI-QLab software elaboration of time-intensity curves, were selected as quantitative parameters and, through statistical analysis, correlated with SES-CD as gold standard.  

SES-CD significantly correlated with MPI (Spearman’s ρ = 0.517, p < 0.002) and slope (β) (Spearman’s ρ = 0.538, p < 0.002). MPI values (39.2-84.3) are significantly higher in patients with SES-CD ≠ 0 (median 61.9, CI 95%) in confront to patients with SES-CD = 0 (median 1.06, CI 95%, 0-51.6): Mann Whitney test p <0.002. β values (4.5-10.1) are significantly higher in patients with SES-CD ≠ 0 (median 27.1, CI 95%) in confront to patients with SES-CD = 0 (median 0.13, CI 95%, 0-6.42): Mann Whitney test p <0.002.  

This study demonstrates that MPI and Slope evaluated by CEUS significantly correlates with SES-CD.

CEUS correlate with endoscopic scoring of active inflammation in CD and improve the reliability of conventional US to detect active inflammation and objectivate the response to the therapies.  

DeFranco, A, Di Veronica, A, Guidi, L, De Vitis, I, Bock, E, Bonomo, L, CEUS in ileal Crohn’s disease: Correlation between Quantitative Parameters and Simple Endoscopic Score for Crohn’s Disease Activity.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9013976.html