Białecki Marcin, Białecka Agnieszka, Laskowska Katarzyna, Kłopocka Maria, Liebert Ariel, Lemanowicz Adam, Serafin Zbigniew
Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Department of Dermatology, Sexually Transmitted Diseases and Immunodermatology, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Pol J Radiol. 2014 Apr 7;79:70-4. doi: 10.12659/PJR.890312. eCollection 2014.
Contrast-enhanced ultrasound (CEUS) is a recent non-invasive modality, which may partially replace currently used techniques (endoscopy, CT enterography and MR enterography) in the diagnostics and assessment of Crohn's disease (CD). The aim of the study was to analyze early experience in the use of CEUS for the measurement of activity and staging of CD.
MATERIAL/METHODS: Eleven patients previously diagnosed with CD were included in the study. They underwent contrast-enhanced ultrasonography (SonoVue, Bracco), low-dose CT enterography (LDCTE), assessment of laboratory markers of inflammation and clinical CD activity index (CDAI). Contrast enhancement was evaluated using a semi-quantitative method and a quantitative method that included measurement of peak enhancement (PE), enhancement curve rise time (RT) and wash-in-rate (WiR).
Ileal wall thickening was observed in all patients. Semi-quantitative method was used to observe CD activity in CEUS in 10 cases that perfectly matched LDCTE findings. There was a moderate positive correlation between PE and CDAI (r=0.65, p<0.001). There was no significant relationship between perfusion parameters and laboratory markers of inflammation.
CEUS is a promising modality for non-invasive assessment of pathologic ileal vascularization in the course of Crohn's disease. Intensity of enhancement in CEUS reflects activity of the disease detected in LDCTE and correlates with CDAI.
超声造影（CEUS）是一种最新的非侵入性检查方法，在克罗恩病（CD）的诊断和评估中可能会部分取代目前使用的技术（内镜检查、CT小肠造影和MR小肠造影）。本研究的目的是分析使用CEUS测量CD活动度和分期的早期经验。
材料/方法：本研究纳入了11例先前诊断为CD的患者。他们接受了超声造影检查（声诺维，博莱科）、低剂量CT小肠造影（LDCTE）、炎症实验室指标评估以及临床CD活动指数（CDAI）评估。使用半定量方法和定量方法评估造影剂增强情况，定量方法包括测量峰值增强（PE）、增强曲线上升时间（RT）和灌注率（WiR）。
所有患者均观察到回肠壁增厚。在10例患者中使用半定量方法观察CEUS中的CD活动度，结果与LDCTE的结果完全匹配。PE与CDAI之间存在中度正相关（r = 0.65，p < 0.001）。灌注参数与炎症实验室指标之间无显著关系。
CEUS是一种很有前景的方法，可用于非侵入性评估克罗恩病病程中病理性回肠血管化情况。CEUS中的增强强度反映了LDCTE中检测到的疾病活动度，并与CDAI相关。
