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01-06-2009 | Gastrointestinal

Comparison of sonographically measured bowel wall vascularity, histology, and disease activity in Crohn’s disease

Authors: B. H. Drews, T. F. E. Barth, M. M. Hänle, A. S. Akinli, R. A. Mason, R. Muche, R. Thiel, S. Pauls, J. Klaus, G. von Boyen, W. Kratzer

Published in: European Radiology | Issue 6/2009

Abstract

The purposes of this study was to provide a retrospective comparison of semiquantitatively measured bowel wall vascularity by power Doppler sonography, endoscopic-histopathological biopsy findings, and disease activity in patients with confirmed Crohn’s disease. Thirty-two out of 1,332 patients with histologically confirmed Crohn’s disease (18 female, 14 male; mean age 38.8 years) met the inclusion criteria: ileocolonoscopy with biopsy and power Doppler sonographic determination of bowel wall vascularity with assessment of disease activity within a period of 5 days. Sonographic determination of bowel wall vascularity was based on a semiquantitative score. Endoscopic bowel wall biopsy specimens were assessed using a self-developed inflammation score and the disease activity was calculated using Crohn’s disease activity index (CDAI). A significant association (p < 0.05) was shown for results of histology and bowel wall vascularity in the terminal ileum (κ = 0.66; sensitivity 95%; specificity 69%). There was no observed association between CDAI and histology, although there was an association between CDAI and bowel wall vascularity (sensitivity 82%). Increased bowel wall vascularity in the terminal ileum measured by power Doppler ultrasound reflects inflammatory activity in histologically examined bowel wall. Power Doppler ultrasound may be able to monitor activity changes of the bowel wall determined by pharmaceutical treatment.

Maconi G, Radice E, Greco S et al (2006) Bowel ultrasound in Crohn’s disease. Best Pract Res Clin Gastroenterol 20:93–112PubMedCrossRef

Schmidt T, Reinshagen M, Brambs HJ et al (2003) Comparison of conventional enteroclysis, intestinal ultrasound and MRI-enteroclysis for determining changes in the small intestine and complications in patients with Crohn’s disease. Z Gastroenterol 41:641–648PubMedCrossRef

Maconi G, Sampietro GM, Parente F et al (2003) Contrast radiology, computed tomography and ultrasonography in detecting internal fistulas and intra-abdominal abscesses in Crohn’s disease: a prospective comparative study. Am J Gastroenterol 98:1545–1555PubMedCrossRef

Parente F, Maconi G, Bollani S et al (2002) Bowel ultrasound in assessment of Crohn’s disease and detection of related small bowel strictures: a prospective comparative study versus x ray and intraoperative findings. Gut 50:490–495PubMedCrossRef

Kohn A, Cerro P, Milite G et al (1999) Prospective evaluation of transabdominal bowel sonography in the diagnosis of intestinal obstruction in Crohn’s disease: comparison with plain abdominal film and small bowel enteroclysis. Inflamm Bowel Dis 5:153–157PubMed

Gasche C, Mioser G, Turetschek K et al (1999) Transabdominal bowel sonography for the detection of intestinal complications in Crohn’s disease. Gut 44:112–117PubMedCrossRef

Maconi G, Bollani S, Bianchi et al (1996) Ultrasonographic detection of intestinal complications in Crohn’s disease. Dig Dis Sci 41:1643–1648PubMedCrossRef

Minderhoud IM, Samsom M, Oldenburg B (2007) What predicts mucosal inflammation in Crohn’s disease patients? Inflamm Bowel Dis 13:1567–1572PubMedCrossRef

Sostegni R, Daperno M, Scaglione N et al (2003) Review article: Crohn’s disease: monitoring disease activity. Aliment Pharmacol Ther 17 Suppl 2:11–17PubMedCrossRef

10.

Kratzer W, Foeller T, Kaechele V et al (2004) Intestinal wall vascularisation in Crohn’s disease. Z Gastroenterol 42:973–978PubMedCrossRef

11.

Neye H, Voderholzer W, Rickes S et al (2004) Evaluation of criteria for the activity of Crohn’s disease by powerdoppler sonography. Dig Dis 22:67–72PubMedCrossRef

12.

Serra C, Menozzi G, Labate AM et al (2007) 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 62:114–121PubMedCrossRef

13.

De Pascale A, Garofalo G, Perna M et al (2006) Contrast-enhanced ultrasonography in Crohn’s disease. Radiol Med (Torino) 111:539–550CrossRef

14.

Rapaccini GL, Pompili M, Orefice R et al (2004) Contrast-enhanced power Doppler of the intestinal wall in the evaluation of patients with crohn disease. Scand J Gastroenterol 39:188–194PubMedCrossRef

15.

Robotti D, Cammarota T, Debani P et al (2004) Activity of Crohn disease: value of color-power-Doppler and contrast-enhanced ultrasonography. Abdom Imaging 29:648–652PubMedCrossRef

16.

Colombel JF, Solem CA, Sandborn WJ et al (2006) Quantitative measurement and visual assessment of ileal Crohn’s disease activity by computed tomography enterography: correlation with endoscopic severity and C reactive protein. Gut 55:1561–1567PubMedCrossRef

17.

Bodily KD, Fletcher JG, Solem CA et al (2006) Crohn disease: mural attenuation and thickness at contrast-enhanced CT enterography–correlation with endoscopic and histologic findings of inflammation. Radiology 238:505–516PubMedCrossRef

18.

Dinter DJ, Chakraborty A, Brade J et al (2008) Endoscopy and magnetic resonance imaging in patients with Crohn’s disease: a retrospective single-centre comparative study. Scand J Gastroenterol 43:207–216PubMedCrossRef

19.

Limberg B (1999) Diagnosis of chronic inflammatory bowel disease by ultrasonography. Z Gastroenterol 37:495–508PubMed

20.

Best WR, Becktel JM, Singleton JW et al (1976) Development of a Crohn’s disease activity index. National Cooperative Crohn’s Disease Study. Gastroenterology 70:439–444PubMed

21.

Stange EF, Travis SP, Vermeire S et al (2006) European Crohn’s and colitis organisation. European evidence based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis. Gut 55 Suppl 1:11–15

22.

Cross SS, Harrison RF (2002) Discriminant histological features in the diagnosis of chronic idiopathic inflammatory bowel disease: analysis of a large dataset by a novel data visualisation technique. J Clin Pathol 55:51–57PubMedCrossRef

23.

Geboes K, Dalle I (2002) Influence of treatment on morphological features of mucosal inflammation. Gut 50 Suppl 3:37–42

24.

Heresbach D, Alexandre JL, Branger B et al (2005) Frequency and significance of granulomas in a cohort of incident cases of Crohn’s disease. Gut 54:215–222PubMedCrossRef

25.

Tanaka M, Riddell RH, Saito H et al (1999) Morphologic criteria applicable to biopsy specimens for effective distinction of inflammatory bowel disease from other forms of colitis and of Crohn’s disease from ulcerative colitis. Scand J Gastroenterol 34:55–67PubMedCrossRef

26.

Deban L, Correale C, Vetrano S et al (2008) Multiple pathogenic roles of microvasculature in inflammatory bowel disease: a Jack of all trades. Am J Pathol 172:1457–1466PubMedCrossRef

27.

Bender R, Ziegler A, Lange S (2002) Logistische regression. Dtsch Med Wochenschr 127:T11–T13

28.

Heyne R, Rickes S, Bock P et al (2002) Non-invasive evaluation of activity in inflammatory bowel disease by power Doppler sonography. Z Gastroenterol 40:171–175PubMedCrossRef

29.

Yekeler E, Danalioglu A, Movasseghi B et al (2005) Crohn disease activity evaluated by Doppler ultrasonography of the superior mesenteric artery and the affected small-bowel segments. J Ultrasound Med 24:59–65PubMed

30.

Rutgeerts P, Löfberg R, Malchow H et al (1994) A comparison of budesonide with prednisolone for active Crohn’s disease. N Engl J Med 331:842–845PubMedCrossRef

31.

D’Haens G, Geboes K, Ponette E et al (1997) Healing of severe recurrent ileitis with azathioprine therapy in patients with Crohn’s disease. Gastroenterology 112:1475–1481PubMedCrossRef

32.

D’Haens G, Geboes K, Rutgeerts P (1999) Endoscopic and histologic healing of Crohn’s (ileo-) colitis with azathioprine. Gastrointest Endosc 50:667–671PubMedCrossRef

33.

Van Dullemen HM, Van Deventer SJ, Hommes DW et al (1995) Treatment of Crohn’s disease with anti-tumor necrosis factor chimeric monoclonal antibody (cA2). Gastroenterology 109:129–135PubMedCrossRef

34.

D’Haens G, Van Deventer S, Van Hogezand R et al (1999) Endoscopic and histologic healing with infliximab anti-tumor necrosis factor antibodies in Crohn’s disease: a European multicenter trial. Gastroenterology 1116:1029–1034CrossRef

Title: Comparison of sonographically measured bowel wall vascularity, histology, and disease activity in Crohn’s disease
Authors: B. H. Drews
T. F. E. Barth
M. M. Hänle
A. S. Akinli
R. A. Mason
R. Muche
R. Thiel
S. Pauls
J. Klaus
G. von Boyen
W. Kratzer
Publication date: 01-06-2009
Publisher: Springer-Verlag
Published in: European Radiology / Issue 6/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-008-1290-5

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Comparison of sonographically measured bowel wall vascularity, histology, and disease activity in Crohn’s disease

Abstract

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Abstract

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