High frequency endosonography of gastrointestinal arteries: Potential and limitations defined in vitro

Quantitative contrast-enhanced ultrasound comparison between inflammatory and fibrotic lesions in patients with Crohn's disease

The aim of this study was to determine whether there are differences in absolute blood flow between patients with Crohn's disease with inflammation or fibrosis using contrast-enhanced ultrasound. Eighteen patients with fibrotic disease and 19 patients with inflammation were examined. Video sequences of contrast data were analyzed using a pharmacokinetic model to extract the arterial input and tissue residue functions with a custom software, enabling calculation of the absolute values for mean transit time, blood volume and flow. Feasibility of the examination was 89%. The fibrosis group had lower blood volume (0.9 vs. 3.4 mL per 100 mL tissue; p = 0.001) and flow (22.6 vs. 45.3 mL/min per 100 mL tissue; p = 0.003) compared with the inflammation group. There was no significant difference in mean transit time (3.9 vs. 5.5 s). In conclusion, absolute perfusion measurement in the gastrointestinal wall using contrast-enhanced ultrasound is feasible. There seems to be reduced blood volume and blood flow in patients with fibrotic disease.

Ultrasonography of the human stomach

Improved technology and new systems have expanded the possibilities of using ultrasound in clinical gastroenterology.

METHODS

Conventional real-time ultrasound was applied to the stomach in order to study motor activity and accommodation to meals. The antrum was imaged by various modalities of two- and three-dimensional ultrasonography, while duplex sonography was used for studying transpyloric flow. Miniature ultrasound probes and echo-endoscopes were employed for endoscopic ultrasound

RESULTS

The examinations provided new information about contractions, distension, co-ordination of movements, and flow. Patients with functional dyspepsia were characterized by rapid emptying of the proximal stomach, wide gastric antrum, early commencement of transpyloric flow, and epigastric discomfort following ingestion of a meat soup. Endoscopic ultrasonography exposed detailed images of the gastric wall and adjacent structures of great importance in clinical decision-making.

CONCLUSIONS

The new ultrasound methods have improved our diagnostic capabilities and opened new promising possibilities for further research in the field of motility.