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CEUS Bowel: IBD
Alexandra Medellin, MD; Stephanie R. Wilson, MD; Benjamin A. Caine, BMSc
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KEY FACTS

  • GENERAL DISCUSSION

    • IMAGING

      TERMINOLOGY

      • Abbreviations

        • Inflammatory bowel disease (IBD)
      • Definitions

        • IBD: Crohn disease (CD) and ulcerative colitis (UC)
          • Chronic conditions with peak onset in adolescence and early adult life
        • CD: Transmural process affecting any portion of GI tract with predilection for terminal ileum
          • Includes inflammatory, penetrating, and fibrostenotic phenotypes
            • Penetrating disease extends beyond bowel serosa into mesenterium
            • Fibrostenotic disease is characterized by luminal narrowing of bowel, frequently associated with bowel obstruction
        • UC: Characterized by superficial mucosal inflammation of colon that extends proximally from anal verge in contiguous manner
        • Comb sign: Represents filling of prominent straight intestinal arterial branches in mesenteric arcade suggesting active disease

      CLINICAL IMPLICATIONS

      • Clinical Importance

        • Clinical Considerations

          • Contributions of US/CEUS

            CEUS TECHNIQUE

            • Bowel Imaging

              IMAGING

              • US/CEUS Findings

                • Determination of Disease Activity

                  • Subjective Assessment

                    • Objective Assessment

                      • Monitoring Response to Therapy

                        • Differentiation of Strictures

                          Selected References

                          1. Maconi G et al: EFSUMB Recommendations and clinical guidelines for intestinal ultrasound (GIUS) in inflammatory bowel diseases. Ultraschall Med. 39(3):304-317, 2018
                          2. Medellin A et al: Role of contrast-enhanced ultrasound in evaluation of the bowel. Abdom Radiol (NY). 43(4):918-933, 2018
                          3. Pecere S et al: Usefulness of contrast-enhanced ultrasound (CEUS) in inflammatory bowel disease (IBD). Dig Liver Dis. 50(8):761-767, 2018
                          4. Mocci G et al: SICUS and CEUS imaging in Crohn's disease: an update. J Ultrasound. 20(1):1-9, 2017
                          5. Medellin-Kowalewski A et al: Quantitative contrast-enhanced ultrasound parameters in Crohn disease: Their role in disease activity determination with ultrasound. AJR Am J Roentgenol. 206(1):64-73, 2016
                          6. Serafin Z et al: Contrast-enhanced ultrasound for detection of Crohn's disease activity: Systematic review and meta-analysis. J Crohns Colitis. 10(3):354-62, 2016
                          7. Braden B et al: Diagnostic value and clinical utility of contrast enhanced ultrasound in intestinal diseases. Dig Liver Dis. 42(10):667-74, 2010
                          8. Ripoll├ęs T et al: Crohn disease: correlation of findings at contrast-enhanced US with severity at endoscopy. Radiology. 253(1):241-8, 2009
                          9. Satsangi J et al: The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 55(6):749-53, 2006
                          Related Anatomy
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                          Related Differential Diagnoses
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                          References
                          Tables

                          Tables

                          KEY FACTS

                          • GENERAL DISCUSSION

                            • IMAGING

                              TERMINOLOGY

                              • Abbreviations

                                • Inflammatory bowel disease (IBD)
                              • Definitions

                                • IBD: Crohn disease (CD) and ulcerative colitis (UC)
                                  • Chronic conditions with peak onset in adolescence and early adult life
                                • CD: Transmural process affecting any portion of GI tract with predilection for terminal ileum
                                  • Includes inflammatory, penetrating, and fibrostenotic phenotypes
                                    • Penetrating disease extends beyond bowel serosa into mesenterium
                                    • Fibrostenotic disease is characterized by luminal narrowing of bowel, frequently associated with bowel obstruction
                                • UC: Characterized by superficial mucosal inflammation of colon that extends proximally from anal verge in contiguous manner
                                • Comb sign: Represents filling of prominent straight intestinal arterial branches in mesenteric arcade suggesting active disease

                              CLINICAL IMPLICATIONS

                              • Clinical Importance

                                • Clinical Considerations

                                  • Contributions of US/CEUS

                                    CEUS TECHNIQUE

                                    • Bowel Imaging

                                      IMAGING

                                      • US/CEUS Findings

                                        • Determination of Disease Activity

                                          • Subjective Assessment

                                            • Objective Assessment

                                              • Monitoring Response to Therapy

                                                • Differentiation of Strictures

                                                  Selected References

                                                  1. Maconi G et al: EFSUMB Recommendations and clinical guidelines for intestinal ultrasound (GIUS) in inflammatory bowel diseases. Ultraschall Med. 39(3):304-317, 2018
                                                  2. Medellin A et al: Role of contrast-enhanced ultrasound in evaluation of the bowel. Abdom Radiol (NY). 43(4):918-933, 2018
                                                  3. Pecere S et al: Usefulness of contrast-enhanced ultrasound (CEUS) in inflammatory bowel disease (IBD). Dig Liver Dis. 50(8):761-767, 2018
                                                  4. Mocci G et al: SICUS and CEUS imaging in Crohn's disease: an update. J Ultrasound. 20(1):1-9, 2017
                                                  5. Medellin-Kowalewski A et al: Quantitative contrast-enhanced ultrasound parameters in Crohn disease: Their role in disease activity determination with ultrasound. AJR Am J Roentgenol. 206(1):64-73, 2016
                                                  6. Serafin Z et al: Contrast-enhanced ultrasound for detection of Crohn's disease activity: Systematic review and meta-analysis. J Crohns Colitis. 10(3):354-62, 2016
                                                  7. Braden B et al: Diagnostic value and clinical utility of contrast enhanced ultrasound in intestinal diseases. Dig Liver Dis. 42(10):667-74, 2010
                                                  8. Ripoll├ęs T et al: Crohn disease: correlation of findings at contrast-enhanced US with severity at endoscopy. Radiology. 253(1):241-8, 2009
                                                  9. Satsangi J et al: The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 55(6):749-53, 2006