Bowel contrast-enhanced ultrasound perfusion imaging in the evaluation of Crohn's disease patients undergoing anti-TNFα therapy

Lucrezia Laterza, Maria Elena Ainora, Matteo Garcovich, Linda Galasso, Andrea Poscia, Enrico Di Stasio, Andrea Lupascu, Laura Riccardi, Franco Scaldaferri, Alessandro Armuzzi, Gian Ludovico Rapaccini, Antonio Gasbarrini, Maurizio Pompili, Maria Assunta Zocco

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Aim: To evaluate whether changes in bowel perfusion parameters measured by dynamic-CEUS (D-CEUS) can be used for monitoring response to therapy in active Crohn disease (CD). Methods: Fifty-four CD patients were evaluated with D-CEUS before (T0) and after 2 (T1), 6 (T2) and 12 weeks (T3) of anti-TNFα therapy. Variations from baseline were calculated for: peak intensity, PI; area under the curve, AUC; slope of wash in, Pw; time to peak, TP; mean transit time, MTT (median percentage values) and were correlated with combined endoscopic/clinical response after 12 weeks and clinical relapse within 6 months. Results: 70% of patients achieved combined endoscopic/clinical response (responders). The reduction in PI, AUC, Pw and MTT between T1 and T0 was higher in responders. Relapsers (21%) showed significantly lower reduction in delta PI and Pw at T1 and T2. At T3 they showed a new increase in PI and lower reduction in delta Pw. In relapsers, AUC showed a significantly lower decrease at T2 and T3, TP showed a significant reduction at T3 and MTT showed a progressive increase at the different time-points, reaching the statistical significance at T3. Conclusions: D-CEUS might become a reliable predictor of combined endoscopic/clinical response and clinical relapse in CD.
Lingua originaleEnglish
pagine (da-a)729-737
Numero di pagine9
RivistaDigestive and Liver Disease
Volume53
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Adult
  • Crohn
  • Crohn Disease
  • Dynamic CEUS
  • Endoscopic remission
  • Female
  • Humans
  • IBD
  • Infliximab
  • Male
  • Middle Aged
  • Perfusion Imaging
  • Prospective Studies
  • Response to therapy
  • Tumor Necrosis Factor Inhibitors
  • Ultrasonography

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