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

Published on Sep 5, 2020in Digestive and Liver Disease3.57
· DOI :10.1016/J.DLD.2020.08.005
Lucrezia Laterza10
Estimated H-index: 10
(CUA: The Catholic University of America),
Maria Elena Ainora11
Estimated H-index: 11
(CUA: The Catholic University of America)
+ 11 AuthorsMaria Assunta Zocco33
Estimated H-index: 33
(CUA: The Catholic University of America)
Sources
Abstract
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.
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