Comparison between a clinical activity index (Harvey-Bradshaw-Index), laboratory inflammation markers and quantitative assessment of bowel wall vascularization by contrast-enhanced ultrasound in Crohn's disease

Eur J Radiol. 2012 Jun;81(6):1105-9. doi: 10.1016/j.ejrad.2011.02.054. Epub 2011 Mar 24.

Abstract

Purpose: Due to its character as a remitting inflammatory disease, patients suffering from Crohn's disease (CD) often undergo several imaging studies subjecting the mostly young patients to ionizing. Contrast enhanced ultrasound for capillary microvascular assessment might be a new diagnostic tool for identifying the activity of inflammation by ultrasound techniques.

Materials and methods: We prospectively evaluated 45 patients with proven Crohn's disease performing contrast enhanced ultrasound (CEUS) and laboratory assessment including C-reactive protein (CRP), leucocytes and hematocrit as well as calculating the Harvey-Bradshaw Index (HBI). Thereafter, we applied the quantification software Qontrast(®) to obtain contrast-enhanced sonographic perfusion maps.

Results: Analysis of the 41 finally included patients revealed a correlation of CRP to HBI and TTP[s], respectively. Moreover, an association was found for HBI and TTP[s] and for HBI and TTP[s]/Peak [%]. Analysis of 34 patients with a Peak [%] ≥ 25 showed a close association of HBI and CRP. Besides, in these patients CRP correlated to TTP[s] and to TTP[s]/Peak [%]. We found a strong negative correlation between HBI and TTP[s] (r = -0.645, p<0.01), thus, the higher the clinical activity the shorter the time-to-peak.

Conclusion: Quantitative evaluation with CEUS, particularly the calculation of TTP[s] in patients with a Peak [%] ≥ 25, provides a simple method to assess the inflammatory activity in CD.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Biomarkers / analysis
  • C-Reactive Protein / analysis
  • Contrast Media
  • Crohn Disease / diagnostic imaging*
  • Crohn Disease / pathology
  • Female
  • Hematocrit
  • Humans
  • Leukocyte Count
  • Male
  • Neovascularization, Pathologic / diagnostic imaging*
  • Phospholipids
  • Prospective Studies
  • Severity of Illness Index*
  • Software
  • Statistics, Nonparametric
  • Sulfur Hexafluoride
  • Ultrasonography

Substances

  • Biomarkers
  • Contrast Media
  • Phospholipids
  • contrast agent BR1
  • C-Reactive Protein
  • Sulfur Hexafluoride