Is there an association between intestinal perfusion and Crohn's disease activity? A feasibility study using contrast-enhanced ultrasound

• Published in: British journal of radiology Vol. 82; no. 974; pp. 112 - 117
• Main Authors: KUMAR, P, DOMJAN, J, BHANDARI, P, ELLIS, R, HIGGINSON, A
• Format: Journal Article
• Language: English
• Published: London British Institute of Radiology 01.02.2009
• Subjects: Adult; Aged; Barium Sulfate; Biological and medical sciences; Blood Flow Velocity; Contrast Media; Crohn Disease - diagnostic imaging; Crohn Disease - physiopathology; Epidemiologic Methods; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Image Interpretation, Computer-Assisted - methods; Intestinal Mucosa; Intestine, Small - diagnostic imaging; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Mesenteric Artery, Superior - diagnostic imaging; Mesenteric Artery, Superior - physiopathology; Middle Aged; Other diseases. Semiology; Phospholipids; Radiography; Splanchnic Circulation; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Sulfur Hexafluoride; Ultrasonography; Young Adult; Sonography; Crohn disease; Nuclear medicine; Perfusion; Echography; Gut; Radiology; Digestive diseases; Intestinal disease; Feasibility; Ultrasound; Inflammatory disease
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr/43430629

A recent study used contrast-enhanced ultrasound to assess splanchnic haemodynamics. This study investigates whether an association exists between disease activity and splanchnic transit time in patients with suspected Crohn's disease. The study protocol had the approval of the local ethics committee, and written informed consent was obtained. 18 patients (11 women; mean age, 40 years; age range, 23-69 years) with suspected or confirmed Crohn's disease were recruited prospectively. A bolus injection of an ultrasound contrast agent was given via a peripheral vein and time-intensity curves of the superior mesenteric artery and vein were analysed. Splanchnic transit time was calculated as the time interval between the rise in signal intensity to >10% above baseline value. Baseline parameters measured included the time-averaged maximum velocity and cross-sectional area of the superior mesenteric artery (SMA). Pearson correlations were used to test associations between different numeric measurements; the independent samples t-test was used to test associations between different numeric measurements; and the independent samples t-test was used to compare mean values between patients with active and inactive disease. There was a weak negative association between splanchnic transit time and the Crohn's Disease Activity Index (CDAI) (r = -0.42), which did not reach statistical significance (p = 0.13), although the mean splanchnic transit time was reduced in the active group (4.0 s vs 6.9 s). The SMA flow rate was significantly greater in active disease (37 ml s(-1) vs 22 ml s(-1); Mann-Whitney U, p = 0.02). This study demonstrates the feasibility of using contrast-enhanced ultrasound as an assessment tool for Crohn's disease.