Contrast-enhanced Perfusion Measurements in Patients with Active Crohn's Disease Using Sonazoid.

Abstract

Purpose: This study aimed to assess the feasibility of dynamic contrast-enhanced ultrasound with Sonazoid, its correlation with disease activity, its ability to differentiate between remission/mild activity and moderate/severe activity, and if a region of interest including the mucosa and submucosa was different compared to one encompassing the entire wall.

Materials and methods: We prospectively studied 48 patients with Crohn's disease who underwent colonoscopy and dynamic contrast-enhanced ultrasound with Sonazoid from 2015 to 2019. We compared the local simple endoscopic score for Crohn's disease in the most affected area with parameters from Vuebox, including peak enhancement, wash-in and wash-out area under the curves, wash-in and wash-out rates, and wash-in perfusion index. Region of interest-1 (ROI-1) included all wall layers, and region of interest-2 (ROI-2) included the mucosa and submucosa. Linear data and normalised data were used. Technical failure or a quality of fit value of<80% was considered a failed examination.

Results: The feasibility of the dynamic contrast-enhanced ultrasound examination was 73%. No significant findings were noted in the linear data ( p >0.05). In the normalised data in both ROI-1 and ROI-2, the local simple endoscopic score for Crohn's disease correlated significantly with peak enhancement ( r =0.38 and r =0.35), wash-in rate ( r =0.34 and r =0.34), and wash-in perfusion index ( r =0.40 and r =0.37) and with wash-in area under the curve ( r =0.36) in ROI-2. In patients with moderate/severe disease peak enhancement, wash-in area under the curve, wash-out area under the curve, wash-in rate, and wash-in perfusion index were significantly higher in both region of interests ( p <0.05). All parameters were significantly different in ROI-1 and ROI-2 ( p <0.05).

Conclusions: Dynamic contrast-enhanced ultrasound parameters can differentiate between remission/mild and moderate/severe activity in Crohn's disease, but the method has relatively low feasibility.