Quaia Emilio
Department of Radiology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy,
Abdom Imaging. 2013 Oct;38(5):1005-13. doi: 10.1007/s00261-013-0014-8.
Crohn's disease (CD) is a chronic transmural inflammatory disease of the gastrointestinal tract characterized by episodes of inflammation alternating with periods of remission. Unenhanced grey-scale ultrasound may evaluate the localisation and the length of the affected intestinal segments and may detect transmural complications, including fistulas, abscesses and phlegmons, but it is less accurate to assess the CD activity. Contrast-enhanced ultrasound has become an important imaging modality in patients with CD for the grading of disease activity, the differentiation between small bowel stricture due to inflammation or mural fibrosis, and for the assessment of the response to specific therapy. New dedicated software packages allow the accurate quantification of the enhancement within the small bowel wall after microbubble contrast agent injection to obtain different kinetic semi-quantitative parameters-the percentage of the maximal enhancement, the time-to-the peak enhancement, and the area under the time-intensity curve-which are very useful to differentiate the inflammatory oedema from fibrosis and to differentiate responders from non-responders to the specific therapy among patients with CD.
克罗恩病（CD）是一种胃肠道的慢性透壁性炎症性疾病，其特征为炎症发作与缓解期交替出现。未增强的灰阶超声可评估受累肠段的定位和长度，并可检测透壁性并发症，包括瘘管、脓肿和蜂窝织炎，但评估CD活动度的准确性较低。超声造影已成为CD患者疾病活动度分级、鉴别炎症性或壁层纤维化所致小肠狭窄以及评估对特定治疗反应的重要成像方式。新的专用软件包允许在注射微泡造影剂后准确量化小肠壁内的增强情况，以获得不同的动力学半定量参数——最大增强百分比、达到峰值增强的时间以及时间-强度曲线下面积——这些参数对于区分炎症性水肿与纤维化以及在CD患者中区分特定治疗的反应者与无反应者非常有用。
