Ultrasound examination with contrast in the diagnosis of inflammatory bowel disease. The results of the pilot study


Cite item

Full Text

Abstract

Aim. Assessment of diagnostic significance of informativeness and security of ultrasonography with contrast enhancement drug SonoVue in the diagnosis of Crohn's disease (CD) and ulcerative colitis (UC). Materials and methods. The pilot conducted a prospective study which involved 15 patients with inflammatory bowel disease (IBD). All patients gave written consent to participate in the study and processing of personal data. The study included adult patients with an established diagnosis of UC and CD, with proven clinical activity of the disease. Activity was evaluated based on clinical and laboratory data on the scale of best (CDAI >150) for patients with CD and on a scale of Trulove-Witts (2-3 stage) and the Mayo index (DAI) for patients with UC. All the patients underwent colonoscopy with biopsy, ultrasound examination of abdominal cavity organs with the study of the vascularization of the intestinal wall (color Doppler, power Doppler, contrast study). Results. The use of contrast showed additional features in the instrumental evaluation of activity of inflammatory process, identification of complications and assessment of prognosis. Conclusion. The results of ultrasound of the bowel with contrast can be used to assess the activity and stage of disease in patients with UC or CD.

About the authors

V V Fomin

I. M. Sechenov First Moscow state medical University, Ministry of Health of Russia (Sechenovskiy University)

член-корр. РАН, д.м.н., проф., проректор по лечебной работе, зав. каф. факультетской терапии №1 лечебного факультета Moscow, Russia

S K Ternovoy

I. M. Sechenov First Moscow state medical University, Ministry of Health of Russia (Sechenovskiy University)

академик РАН, д.м.н., проф., зав. каф. лучевой диагностики и лучевой терапии лечебного факультета Moscow, Russia

V M Makhov

I. M. Sechenov First Moscow state medical University, Ministry of Health of Russia (Sechenovskiy University)

д.м.н., проф. каф. факультетской терапии №1 лечебного факультета Moscow, Russia

M A Isaykina

I. M. Sechenov First Moscow state medical University, Ministry of Health of Russia (Sechenovskiy University)

Email: manon_17@mail.ru
аспирант каф. факультетской терапии №1 лечебного факультета Moscow, Russia

N A Dzhenzhera

I. M. Sechenov First Moscow state medical University, Ministry of Health of Russia (Sechenovskiy University)

к.м.н., зав. отд-нием ультразвуковой диагностики Университетской клинической больницы №1 Moscow, Russia

T V Turko

I. M. Sechenov First Moscow state medical University, Ministry of Health of Russia (Sechenovskiy University)

к.м.н., врач гастроэнтерологического отд-ния №2 Университетской клинической больницы Moscow, Russia

L N Ugryumova

I. M. Sechenov First Moscow state medical University, Ministry of Health of Russia (Sechenovskiy University)

к.м.н., зав. гастроэнтерологическим отде-нием №2 Университетской клинической больницы №1 Moscow, Russia

O V Babenko

I. M. Sechenov First Moscow state medical University, Ministry of Health of Russia (Sechenovskiy University)

к.м.н., доц., гл. врач Университетской клинической больницы №1 Moscow, Russia

References

  1. Белоусова Е.А. Язвенный колит и болезнь Крона. Тверь: Триада; 2002. 128 с.
  2. Халиф И.Л., Лоранская И.Д. Воспалительные заболевания кишечника (неспецифический язвенный колит и болезнь Крона): клиника, диагностика, лечение. Москва: Миклош; 2004. 88 с.
  3. D’Incà R, Caccaro R. Measuring disease activity in Crohn’s disease: what is currently available to the clinician. Clin Exp Gastroenterol 2014;7:151-61. doi: 10.2147/CEG.S41413
  4. Cellier C, Sahmoud T, Froguel E, et al. Correlations between clinical activity, endoscopic severity, and biological parameters in colonic or ileoco lonic Crohn’s disease: a prospective multicentre study of 121 cases. Gut. 1994;35:231-5.
  5. Ansari A, Soon S.Y, Saunders B.P, Sanderson J.D. A prospective study of the technical feasibility of ileoscopy at colonoscopy. Scand J Gastroenterol. 2003;38:1184-6.
  6. Vilela E.G, Torres H.O.D.G, Martins F.P, Ferrari M.D, Andrade M.M, Da Cunha A.S. Evaluation of inflammatory activity in Crohn’s disease and ulcerative colitis. World J Gastroenterol. 2012;18:872-81. doi: 10.3748/ wjg.v18.i9.872.
  7. Van de Bruaene C, De Looze D, Hindryckx P. Small bowel capsule endoscopy: where are we after almost 15 years of use? World J Gastrointest Endosc. 2015;7:13-36. doi: 10.4253/wjge.v7.i1.13
  8. Dambha F, Tanner J, Carroll N. Diagnostic imaging in Crohn’s disease: what is the new gold standard? Best Pract Res Clin Gastroenterol. 2014;28:421-36. doi: 10.1016/j.bpg.2014.04.010
  9. Sinha R, Verma R, Verma S, Rajesh A. MR enterography of Crohn disease. Part 1. Rationale, technique, and pitfalls. AJR Am J Roentgenol. 2011;197:76-9. doi: 10.2214/AJR.10.7253
  10. Israeli E, Ying S, Henderson B, Mottola J, Strome T, Bernstein C.N. The impact of abdominal computed tomography in a tertiary referral centre emergency department on the management of patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2013;38:513-21. doi: 10.1111/apt.12410
  11. Cipriano L.E, Levesque B.G, Zaric G.S, Loftus E.V. Jr., Sandborn W.J. Cost - effectiveness of imaging strategies to reduce radiation - induced cancer risk in Crohn's disease. Inflamm Bowel Dis. 2012;18:1240-8. doi: 10.1002/ibd.21862
  12. Peloquin J.M, Pardi D.S, Sandborn W.J, Fletcher J.G, Mc Collough C.H, Schueler B.A, et al. Diagnostic ionizing radiation exposure in a population - based cohort of patients with inflammatory bowel disease. Am J Gastroenterol. 2008;103:2015-22. doi: 10.1111/j.1572-0241.2008. 01920
  13. Sheth R.A, Gee M.S. The role of imaging in inflammatory bowel disease evaluation. In: Karoui S, ed. Inflammatory bowel disease: advances in pathogenesis and management. Rijeka, Croatia: InTech; 2012. P. 137-50.
  14. Masselli G. MR imaging of the small bowel. Radiology. 2012;264:333-48. doi: 10.1148/radiol.12111658
  15. Panes J, Bouhnik Y, Reinisch W, et al. Imaging techniques for assessment of inflammatory bowel disease: joint ECCO and ESGAR evidence - based consensus guidelines. J Crohns Colitis. 2013;7:556-85. doi: 10.1016/j.crohns.2013.02.020
  16. Panes J, Bouzas R, Chaparro M, Garcia-Sanchez V, Gisbert J.P, Martinez de Guerenu B, Mendoza J.L, Paredes J.M, Quiroga S, Ripolles T, Rimola J. Systematic review: The use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn’s disease. Aliment Pharmacol Ther. 2011;34:125-45. doi: 10.1111/j.1365-2036. m2011.04710.x
  17. Sasaki T, Kunisaki R, Kinoshita H, et al. Use of color Doppler ultrasonography for evaluating vascularity of small intestinal lesions in Crohn’s disease: correlation with endoscopic and surgical macroscopic findings. Scand J Gastroenterol. 2014;49:295-301. doi: 10.3109/ 00365521.2013.871744
  18. Horsthuis K, Bipat S, Bennink R, Stoker J. Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: meta - analysis of prospective studies. Radiology. 2008;247:64-79. doi: 10.1148/radiol.2471070611
  19. Xuelei M, Yanyan Li, Hongyuan Jia, Jing Zhang, Guoping Wang, Xiaoxiao Liu, Yanlin Song. Contrast - enhanced ultrasound in the diagnosis of patiens suspected of having active Crohns disease: meta - analysis. Ultrasound Med Biol. 2015;41:659-68. doi: 10.1016/j.ultrasmedbio.2014.09.013
  20. Taylor S, Mallett S, Bhatnagar G, et al. METRIC (MR enterography or ultrasound in Crohn’s disease): a study protocol for a multicentre, non - randomised, single - arm, prospective comparison study of magnetic resonance enterography and small bowel ultrasound compared to a reference standard in those. BMC Gastroenterol. 2014;14:142. doi: 10.1186/ 1471-230X-14-142
  21. Parente F, Greco S, Molteni M, et al. Role of early ultrasound in detecting inflammatory intestinal disorders and identifying their anatomical loca - tion within the bowel. Aliment Pharmacol Ther. 2003;18:1009-16.
  22. Bodily K, Fletcher J, Solem C, et al. Crohn disease: mural attenuation and thickness at contrast - enhanced CT enterography - correlation with endoscopic and histologic findings of inflammation. Radiology. 2006;238:505-16.
  23. Esteban J, Maldonado M, Sanchiz V, Minguez M, Benages A. Activity of Crohn’s disease assessed by colour Doppler ultrasound analysis of the affected loops. Eur Radiol. 2001;11:1423-8.
  24. Spalinger J, Patriquin H, Miron M.C, et al. Doppler US in patients with Crohn disease: vessel density in the diseased bowel reflects disease activity. Radiology. 2000;217:787-91.
  25. Medellin-Kowalewski A, Wilkens R, Wilson A, Ruan J, Wilson S.R. Quantitative Contrast-Enhanced Ultrasound Parameters in Crohn Disease: Their Role in Disease Activity Determination With Ultrasound. AJR Am J Roentgenol. 2016 Jan;206(1):64-73. doi: 10.2214/ AJR. 15.14506
  26. Fraquelli M, Colli A, Casazza G, et al. Role of US in detection of Crohn disease: meta - analysis. Radiology. 2005;236:95-101.
  27. Miao Y, Koh D.M, Amin Z, et al. Ultrasound and magnetic resonance imaging assessment of active bowel segments in Crohn’s disease. Clin Radiol. 2002;57:913-8.
  28. Rigazio C, Ercole E, Laudi C, et al. Abdominal bowel ultrasound can predict the risk of surgery in Crohn’s disease: proposal of an ultrasonographic score. Scand J Gastroenterol. 2009;44:585-93.
  29. Danese S, Sans M, de la Motte C, et al. Angiogenesis as a novel component of inflammatory bowel disease pathogenesis. Gastroenterology. 2006;130:2060-73.
  30. Romanini L, Passamonti M, Navarria M, et al. Quantitative analysis of contrast - enhanced ultra - sonography of the bowel wall can predict disease activity in inflammatory bowel disease. Eur J Radiol. 2014; 83:1317-23. doi: 10.1016/j.ejrad.2014.05.012.
  31. Ripollés T, Martínez-Pérez M.J, Blanc E, et al. Contrast - enhanced ultrasound (CEUS) in Crohn’s disease: technique, image interpretation and clinical applications. Insights Imaging. 2011;2:639-52.
  32. Greis C. Quantitative evaluation of microvascular blood flow by contrast - enhanced ultrasound (CEUS). Clin Hemorheol Microcirc. 2011; 49:137-49.
  33. Wilkens R, Pournazari P, Wilson S. CEUS of the bowel in inflammatory bowel disease. 2nd ed. London, UK: International Medical Publishers; 2013. P. 222-9.
  34. Ripollés T, Martínez M.J, Paredes J.M, Blanc E, Flors L, Delgado F. Crohn disease: correlation of findings at contrast - enhanced US with severity at endoscopy. Radiology. 2009;253:241-8.
  35. Ripollés T, Rausell N, Paredes J.M, Grau E, Martínez M.J, Vizuete J. Effectiveness of contrast - enhanced ultrasound for characterisation of intestinal inflammation in Crohn’s disease: a comparison with surgical histopathology analysis. J Crohns Colitis. 2013;7:120-8. doi: 10.1016/ j.crohns.2012.03.002
  36. Serra C, Menozzi G, Labate A.M, Giangregorio F, Gionchetti P, Beltrami M, Robotti D, Fornari F, Cammarota T. Ultrasound assessment of vascularization of the thickened terminal ileum wall in Crohn's disease patients using a low - mechanical index real - time scanning technique with a second generation ultrasound contrast agent. Eur J Radiol. 2007 Apr;62(1):114-21.

Copyright (c) 2018 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies