Differentiation of Inflammatory From Fibrotic Ileal Strictures among Patients with Crohn's Disease Based on Visual Analysis: Feasibility Study Combining Conventional B-Mode Ultrasound, Contrast-Enhanced Ultrasound and Strain Elastography.

The aim of this pilot study was to assess prospectively the feasibility of conventional B-mode ultrasound (US) and contrast-enhanced ultrasound (CEUS) combined with real-time strain elastography (SE) in the differentiation of inflammatory from fibrotic ileal strictures among patients with Crohn's disease (CD) based on visual analysis. Twenty non-consecutive patients (15 male and 5 female; mean age ± standard deviation, 40.2 ± 10.22 y) with CD and stricture of the terminal ileal loop were scanned by conventional B-mode US and CEUS and, subsequently, by real-time SE. Two independent readers visually classified each bowel stricture as fibrotic or inflammatory based on conventional B-mode US, CEUS, SE, individually and then for all techniques combined. All techniques combined had a higher (p <0.05) sensitivity (reader 1, 9/20 [45%]; reader 2, 7/20 [35%]), specificity (reader 1, 5/20 [25%]; reader 2, 8/20 [40%]) and diagnostic accuracy (reader 1, 14/20 [70%]; reader 2, 15/20 [75%]) and higher (p <0.05) area under the receiver operating characteristic curve (reader 1, 0.953; reader 2, 0.921) than individual techniques. Inter-reader agreement was fair for conventional B-mode US (k = 0.46) and CEUS (k = 0.39), moderate for SE (k = 0.6) and fair for all techniques combined (k = 0.38). Conventional B-mode US and CEUS, in combination with SE, may improve differentiation of inflammatory from fibrotic ileal strictures among patients with CD based on visual analysis.

Quaia E ，Gennari AG ，Cova MA ，van Beek EJR ... -  《-》

Feasibility of CEUS and strain elastography in one case of ileum Crohn stricture and literature review.

Giannetti A ，Biscontri M ，Matergi M ，Stumpo M ，Minacci C ... -  《-》

Real-Time Shear Wave Ultrasound Elastography Differentiates Fibrotic from Inflammatory Strictures in Patients with Crohn's Disease.

Chen YJ ，Mao R ，Li XH ，Cao QH ，Chen ZH ，Liu BX ，Chen SL ，Chen BL ，He Y ，Zeng ZR ，Ben-Horin S ，Rimola J ，Rieder F ，Xie XY ，Chen MH ... -  《-》

Ultrasound Shear Wave Elastography and Contrast Enhancement: Effective Biomarkers in Crohn's Disease Strictures.

Lu C ，Gui X ，Chen W ，Fung T ，Novak K ，Wilson SR ... -  《-》

The value of small bowel wall contrast enhancement after sulfur hexafluoride-filled microbubble injection to differentiate inflammatory from fibrotic strictures in patients with Crohn's disease.

We analysed the value of contrast-enhanced ultrasound to differentiate inflammatory from fibrotic ileal strictures in patients with Crohn's disease (CD). Twenty-eight patients (17 male and 11 female; mean age ± SD, 48.5 ± 17.17 years) with a biopsy-proven diagnosis of CD were included. In each patient, the terminal ileal loop was scanned by a convex-array probe (2-5 MHz) before and after sulphur hexafluoride-filled microbubble injection. The digital cine-clip registered after microbubble injection during the first-pass dynamic enhancement was quantified in gray-scale levels by a dedicated software through manually drawn regions-of-interest (ROIs) encompassing the anterior bowel wall. Time-intensity curves from patients with inflammatory and fibrotic ileal strictures, fitted according to the theoretical gamma variate curve, were compared. Inflammatory vs. fibrotic ileal strictures differed in the percentage of maximal enhancement (45.86 ± 5.32 vs. 37.33 ± 16.24%; p < 0.05) and area under the enhancement curve (1168.25 ± 437.65 vs. 570.47 ± 323.08; p < 0.05), whereas the difference in time to peak enhancement was found not significant (9.25 ± 4.21 vs. 12.01 ± 7.34 s; p > 0.05). The quantitative analysis of small bowel wall contrast enhancement after microbubble contrast agent injection may differentiate inflammatory from fibrotic ileal strictures in patients with CD.

Quaia E ，De Paoli L ，Stocca T ，Cabibbo B ，Casagrande F ，Cova MA ... -  《-》