Comparison between Preoperative Quantitative Assessment of Bowel Wall Vascularization by Contrast-Enhanced Ultrasound and Operative Macroscopic Findings and Results of Histopathological Scoring in Crohn's Disease
Comparison between Preoperative Quantitative Assessment of Bowel Wall Vascularization by Contrast-Enhanced Ultrasound and Operative Macroscopic Findings and Results of Histopathological Scoring in Crohn's Disease
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DOI：
10.1055/s-0029-1245398
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发表时间：
2011-04-01
影响因子：
3.4
通讯作者：
Schacherer, D.
中科院分区：
文献类型：
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作者：
Girlich, C.;Jung, E. M.;Schacherer, D.
目的：克罗恩病 (CD) 患者经常接受多项放射影像学检查（MRI 和 US 除外），这些检查使患者接受电离辐射。因此，已经努力使用超声技术来识别炎症活动。我们研究的目的是使用超声造影 (CEUS) 和用于灌注评估的特定量化软件来描述 CD 发炎肠壁的灌注模式。此外，我们将这些结果与手术肉眼观察结果以及应用先进的组织病理学评分系统的手术标本的经顶膜组织病理学结果进行了比较。 材料和方法：我们前瞻性地对 20 名连续患有 CD 的患者进行了 CEUS 检查，并计划在未来 15 天内因 CD 进行肠道手术。然后，我们应用量化软件 Qontrast (R) 来获得对比增强的超声灌注图。外科医生根据维也纳分类定义 CD 的临床行为。然后病理学家使用先进的评分系统对切除的节段进行评估。我们比较了 CEUS 结果、肉眼观察结果和组织病理学评分。结果：我们发现组织病理学评分和达峰时间 (UP) 之间存在很强的负相关性 (r = - 0.677，p < 0.01)。此外，我们发现 UP 与组织病理学评分系统的单个参数之间存在很强的相关性。 结论：超声作为一种广泛使用的无辐射成像方法，更适合评估 CD 的炎症活动，特别是因为超声检查结果与组织病理学评分系统显着相关。
Purpose: Patients with Crohn's disease (CD) often undergo several radiological imaging studies, which - with the exception of MRI and US - subject patients to ionizing radiation. Thus, efforts have been made to identify the inflammation activity using ultrasound techniques. The aim of our study was to describe the perfusion pattern of the inflamed bowel wall in CD using contrast-enhanced ultrasound (CEUS) and specific quantification software for perfusion assessment. Moreover, we compared these findings with the operative macroscopic findings as well as with the transparietal histopathological findings of surgical specimens applying an advanced histopathological scoring system.Materials and Methods: We prospectively performed CEUS in 20 consecutive patients with proven CD and planned bowel surgery due to CD within the next 15 days. We then applied the quantification software Qontrast (R) to obtain contrast-enhanced sonographic perfusion maps. The surgeon defined the clinical behavior of CD according to the Vienna classification. The resected segments were then assessed by a pathologist using an advanced scoring system. We compared the results of CEUS, macroscopic findings and histopathological scoring.Results: We found a strong negative correlation (r = - 0.677, p < 0.01) between the histopathological score and the time-to-peak (UP). Moreover, we detected a strong correlation between UP and single parameters of the histopathological scoring system.Conclusion: Ultrasound as a widely available radiation-free imaging method would be preferable for assessing inflammatory activity of CD, particularly since the ultrasound findings correlate significantly with a histopathological scoring system.