Laura Romanini, Presenter: Nothing to Disclose

Matteo Passamonti MD, Abstract Co-Author: Nothing to Disclose

Mario Navarria, Abstract Co-Author: Nothing to Disclose

Fabrizio Calliada MD, Abstract Co-Author: Nothing to Disclose

Luigi Grazioli MD, Abstract Co-Author: Nothing to Disclose

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

In order to demonstrate the accuracy of the semi-quantitative analysis of the enhancement of the bowel wall after CEUS in patients with Inflammatory Bowel Disease (IBD), as objective evaluation, the results were related to an objective “quantitative” histopathologic analysis of same bowel wall: the count of vessels after haematoxylin and eosin stain and CD34, considered a quantifiable marker of inflammation.

33 patients with IBD were studied blindly and consecutively with CEUS just after colonoscopy with biopsy. The routine histological exam was completed by the count of the vessels in 10 optical fields with high magnification (40x) after haematoxylin and eosin stain and CD34. The data considered were: type of IBD, presence or absence of symptoms, therapy, CPR value, the disease degree by endoscopic, histological and ultrasound and CEUS examination. They were related to the count of vessels and the enhancement quantitative evaluation by Qontrast (e-AMID/BRACCO): PEAK%: peak value; TTPs: time to peak; RBV: regional blood volume; RBF: regional blood flow; MTTs: mean transit time Statistical analysis was carried out with Fisher’s Test, t-test and ROC curve study.  

21/33 patients (Group 1) resulted affected by active disease at the endoscopic, histological and US/CEUS study; and 12/33 patients (Group 0)showed quiescent disease. The count of vessels at the histopathologic examination demonstrated a significant different range between the two groups: mean of 349 vessels in Group 1 and mean of 148 in the Group 0. Results of quantitative evaluation were statistically significant respect to the number of vessels: active patients reach the peak (which is higher) earlier, and both the volume and regional blood flow are higher in these patients. The statistical analysis demonstrates a cutoff value of Peak%. TTPs, and RBF in order to distinguish active or non active disease. RBF is the value that best allows assessment of the active disease versus the inactive one.  

The study demonstrates high accuracy of this semi-quantitative analysis of the enhancement to evaluate the activity degree.

CEUS with quantitative analysis accurately demonstrates the activity degree of the IBD disease and is recommended as follow-up tool and to monitor therapy especially in young Patients instead of CT.

Romanini, L, Passamonti, M, Navarria, M, Calliada, F, Grazioli, L, Maroldi, R, Contrast-enhanced Ultrasound (CEUS): Quantitative Analysis of the Enhancement of the Bowel Wall in Patients with Inflammatory Bowel Diseases (IBD) Can Express the Disease Activity Score by a Numerical and Repeatable Value.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004892.html