Contrast-enhanced ultrasound (CEUS) in Crohn's disease: technique, image interpretation and clinical applications.
Contrast-enhanced ultrasound (CEUS) in Crohn's disease: technique, image interpretation and clinical applications.
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DOI：
10.1007/s13244-011-0124-1
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发表时间：
2011-12
影响因子：
4.7
通讯作者：
Vilar, Jose
中科院分区：
文献类型：
--
作者：
Ripolles, Tomas;Martinez-Perez, Maria J;Blanc, Esther;Delgado, Fructuoso;Vizuete, Jose;Paredes, Jose M;Vilar, Jose
最近的荟萃分析表明，在评价克罗恩病（CD）时，不同成像技术（US、MRI和CT）的诊断准确性无显著差异。高分辨率肠道超声已成为CD患者诊断和随访的替代成像技术，在检测疾病的壁内和壁外扩展方面与CT和MR一样准确。B型超声可以评估受影响肠段的位置和长度，并允许识别透壁并发症、狭窄和肠梗阻。多普勒技术是可视化和量化肠血管化的工具。对比增强超声（CEUS）是一种新技术，涉及静脉注射超声造影剂并进行实时检查，可准确显示肠壁微血管和肠周组织。成像定量技术的引入使得能够对增强进行客观定量测量。本文就超声造影的技术、超声表现、优点和局限性以及临床应用作一综述。目前，CEUS在CD中的应用包括：CD活性评估、炎性肿块的评价、区分纤维化和炎症、通过区分纤维化和炎症来表征狭窄、监测药物治疗的疗效和改善疾病复发的检测。CEUS是一种新兴技术，是整个超声评价的一部分，在CD的诊断和随访中发挥作用，从而改善治疗计划和监测治疗效果。本文的在线版本（doi：10.1007/s13244-011-0124-1）包含补充材料，可供授权用户使用。
Recent meta-analysis has demonstrated no significant differences in diagnostic accuracy among different imaging techniques (US, MRI and CT) in the evaluation of Crohn’s disease (CD). High-resolution bowel ultrasound has emerged as an alternative imaging technique for the diagnosis and follow-up of patients with CD, being as accurate as CT and MR for detecting intramural and extramural extension of the disease. B-Mode US can evaluate the localization and length of the affected intestinal segments and allow identification of transmural complications, stenosis and intestinal obstruction. Doppler techniques are tools that visualize and quantify bowel vascularization. Contrast-enhanced ultrasound (CEUS) is a new technique that involves IV administration of an ultrasound contrast agent with real-time examination, providing an accurate depiction of the bowel wall microvascularization and the perienteric tissues. The introduction of imaging quantification techniques enables an objective quantitative measurement of the enhancement. The article reviews the technique, sonographic findings, advantages and limitations, and clinical applications of contrast-enhanced US in the evaluation of Cohn’s disease. Current CEUS applications in CD are: CD activity assessment, evaluation of inflammatory masses, distinguishing phlegmons from abscesses, characterization of stenosis by differentiating fibrosis from inflammation, monitoring the efficacy of drug treatments and improving the detection of disease recurrence. CEUS is an emerging technique that is part of the entire sonographic evaluation, with a role in the diagnosis and follow-up of CD, thus improving therapy planning and monitoring of the efficacy of treatment. The online version of this article (doi:10.1007/s13244-011-0124-1) contains supplementary material, which is available to authorized users.