Contrast-enhanced wideband harmonic imaging ultrasound (SonoVue®):: A new technique for quantifying bowel wall vascularity in Crohn's disease

Objective. To assess the possibility of quantitative determination of bowel wall vascularity using contrast-enhanced (SonoVue(R)) wideband harmonic imaging ultrasound and the HDI-Lab software in patients with Crohn's disease. Material and methods. Twenty-one patients (13 F, 8 M, average age 33.8 +/- 12.7 years, range 21-60 years) with histologically confirmed Crohn's disease and bowel wall thickness >= 5 mm were recruited for the study. All ultrasound examinations were performed using a Philips HDI 5000 scanner. Bowel wall vascularity was determined at the site of maximum bowel wall thickness at baseline and at 30, 60, 90 and 120 s following application of the contrast enhancer SonoVue (1.2 ml) using the HDI-Lab software. Results. The mean length of bowel segments exhibiting increased wall thickness was 122.3 mm (range: 23-350 +/- 74.7 mm), with a mean wall thickness of 7.6 +/- 1.2 mm. Onset of echo enhancement secondary to contrast medium application was observed after an average 13.4 s (range 7 -19 +/- 4.2 s). Echo intensity corresponding to maximum vascularity was measured 30 s after application of contrast medium. Maximum average contrast medium uptake was 217.5% (range 118-466 +/- 100.1%). Conclusions. It is possible to quantify bowel wall vascularity accurately in patients with Crohn's disease using contrast-enhanced pulse inversion ultrasound (low-MI).