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Zhang C, Zheng C, Zhang Z, Yan X, Xu J, Gu C, Nie F. Quantitative analysis of contrast-enhanced ultrasound and superb microvascular imaging for the evaluation of disease activity in inflammatory bowel disease. Clin Hemorheol Microcirc 2024:CH242114. [PMID: 38788062 DOI: 10.3233/ch-242114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
OBJECTIVE To evaluate the effectiveness of conventional US (ultrasound), SMI (superb microvascular imaging), and CEUS (contrast-enhanced ultrasound) features for the assessment of the activity of inflammatory bowel disease. METHODS Conventional US, CEUS and SMI features of 76 patients were retrospectively analyzed. Patients were categorized into two groups: active group (n = 57) and inactive group (n = 19), with endoscopic results as reference standard. Results in the active group and inactive group were compared using an independent t-test, Mann-Whitney U test, chi-square test, and receiver operating characteristic curve (ROC) analysis. Cut-off values were determined using ROC analysis, and sensitivity and specificity were calculated. US quantitative and TIC-based quantitative parameters were analyzed, and each patient was scored based on the parameters that are statistically significant and immediately available in the clinic to evaluate the diagnostic ability of conventional US, SMI, and CEUS features for active IBD patients. RESULTS Qualitative parameters such as CEUS enhancement pattern I/II, LimbergIII/IV, and lost bowel stratification were reliable indicators of active patients. Quantitative parameters such as bowel thickness and VI of mSMI were reliable indicators of active patients. Patients scored based on these statistically significant parameters with a score ≥3, were highly suspected to be active patients. For TIC-based quantitative parameters, PE, WiAUC, WoAUC, WiWoAUC, WiR, WiPI, and WoR were statistically significant in the differentiation of active IBD from inactive IBD. CONCLUSIONS Conventional US, SMI, and CEUS features may help in the differentiation of active IBD from inactive IBD and have potential application value in the choice of treatment options.
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Affiliation(s)
- Chi Zhang
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
| | - Chunyao Zheng
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
| | - Zhiqi Zhang
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
| | - Xueliang Yan
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
| | - Jianhua Xu
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
| | - Changyan Gu
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
| | - Fang Nie
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
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Contrast-Enhanced Ultrasound (CEUS) in Non-Traumatic Abdominal Emergencies. Ultrasound Int Open 2021; 6:E76-E86. [PMID: 33728394 PMCID: PMC7954641 DOI: 10.1055/a-1347-5875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 05/01/2021] [Indexed: 02/08/2023] Open
Abstract
Conventional ultrasound imaging (US) is the first-line investigation in acute
non-traumatic abdominal emergencies, but sometimes it needs further
examinations, such as computed tomography (CT), to reach a certain
diagnosis. Contrast-enhanced ultrasound (CEUS), through injection of
contrast medium, may provide the radiologist with additional information
that could not be investigated with baseline US. It could help reach a
diagnosis and rapidly determine the proper therapy in an emergency setting.
The purpose of this review is to explain and illustrate the various
possibilities and limitations of CEUS in acute non-traumatic abdominal
diseases, in particular acute inflammation, parenchymal infarcts, and
hemorrhages.
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Enhanced Resorption of Liposomal Packed Vitamin C Monitored by Ultrasound. J Clin Med 2020; 9:jcm9061616. [PMID: 32466592 PMCID: PMC7356785 DOI: 10.3390/jcm9061616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/20/2020] [Accepted: 05/25/2020] [Indexed: 12/20/2022] Open
Abstract
Vitamin C is an essential nutrient for humans and is involved in a plethora of health-related functions. Several studies have shown a connection between vitamin C intake and an improved resistance to infections that involves the immune system. However, the body cannot store vitamin C and both the elevated oral intake, and the intravenous application have certain disadvantages. In this study, we wanted to show a new formulation for the liposomal packaging of vitamin C. Using freeze etching electron microscopy, we show the formed liposomes. With a novel approach of post-processing procedures of real-time sonography that combines enhancement effects by contrast-like ultrasound with a transducer, we wanted to demonstrate the elevated intestinal vitamin C resorption on four participants. With the method presented in this study, it is possible to make use of the liposomal packaging of vitamin C with simple household materials and equipment for intake elevation. For the first time, we show the enhanced resorption of ingested liposomes using microbubble enhanced ultrasound imaging.
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Weber D, Weber M, Hippe K, Ghimire S, Wolff D, Hahn J, Evert M, Herr W, Holler E, Jung EM. Non-invasive diagnosis of acute intestinal graft-versus-host disease by a new scoring system using ultrasound morphology, compound elastography, and contrast-enhanced ultrasound. Bone Marrow Transplant 2018; 54:1038-1048. [PMID: 30401964 DOI: 10.1038/s41409-018-0381-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 09/13/2018] [Accepted: 09/27/2018] [Indexed: 12/19/2022]
Abstract
Acute gastrointestinal (GI) graft-versus-host disease (GvHD) is a life-threating complication in patients after allogeneic stem cell transplantation (ASCT). In 60 sonographic analyses, a novel scoring system for non-invasive diagnosis of severe GI GvHD was developed. The score comprised morphological and vascular changes using B-mode and color-coded Doppler sonography, changes of mural stiffness using compound elastography, and dynamic microvascularisation using contrast-enhanced ultrasound (CEUS). Furthermore, inflammatory parameters such as CRP, Calprotectin, and regenerating islet-derived protein 3α (Reg3α) were obtained. ROC curve analysis of our novel GvHD sum score revealed an area under the curve of 1.0 (95% CI: 0.99-1.00) in diagnosing GI GvHD and 0.88 (95% CI: 0.79-0.96) for severe GI GvHD. A sum score above 5 correlated with GI GvHD with a sensitivity of 97.6% (41/42) and a specificity of 94.4% (17/18) and score values above 10 with severe GI GvHD with a sensitivity of 91.7% (11/12) and specificity of 79.2% (38/48). The additional use of inflammatory parameters did not improve the predictive power. CEUS is a promising, non-invasive tool for the diagnosis of acute GI GvHD. Together with further descriptive parameters for inflammatory processes, it gains significant diagnostic accuracy in identifying patients with severe stages of acute intestinal GvHD.
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Affiliation(s)
- Daniela Weber
- Department of Hematology and Oncology, Internal Medicine III, University Medical Center- Regensburg, Regensburg, Germany.
| | - Markus Weber
- Department of Orthopedic Surgery, University Medical Center-Regensburg, Regensburg, Germany
| | - Katrin Hippe
- Department of Pathology, University Medical Center-Regensburg, Regensburg, Germany
| | - Sakhila Ghimire
- Department of Hematology and Oncology, Internal Medicine III, University Medical Center- Regensburg, Regensburg, Germany
| | - Daniel Wolff
- Department of Hematology and Oncology, Internal Medicine III, University Medical Center- Regensburg, Regensburg, Germany
| | - Joachim Hahn
- Department of Hematology and Oncology, Internal Medicine III, University Medical Center- Regensburg, Regensburg, Germany
| | - Matthias Evert
- Department of Pathology, University Medical Center-Regensburg, Regensburg, Germany
| | - Wolfgang Herr
- Department of Hematology and Oncology, Internal Medicine III, University Medical Center- Regensburg, Regensburg, Germany
| | - Ernst Holler
- Department of Hematology and Oncology, Internal Medicine III, University Medical Center- Regensburg, Regensburg, Germany
| | - Ernst-Michael Jung
- Department of Radiology, University Medical Center-Regensburg, Regensburg, Germany
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Zhang F, Miao LY, Ge HY, Tan S, Li ZQ, Zhao B. Usefulness of Contrast-Enhanced Ultrasound in Differentiating Inflammatory Bowel Disease From Colon Cancer. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:124-133. [PMID: 29126753 DOI: 10.1016/j.ultrasmedbio.2017.09.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 09/13/2017] [Accepted: 09/19/2017] [Indexed: 06/07/2023]
Abstract
To evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in differential diagnosis of inflammatory bowel disease (IBD) and colon cancer, we enrolled 51 patients with thickened bowel walls (13 with IBD and 38 with colon cancer). Ultrasound and CEUS were performed and both qualitative and quantitative features were analyzed. The intestinal wall stratification was preserved in 63.6% of the IBD group but in only 2.6% of the colon cancer group (p <0.01). On CEUS, disordered enhancement and heterogeneous enhancement were shown in only 9.1% and 0%, respectively, of the IBD group while in 94.7% and 78.9%, respectively, of the colon cancer group (p <0.01). For quantitative analysis, compared to IBD, colon cancer showed later enhancement and slower wash-out with less speed to reach peak intensity (p <0.05). In conclusion, CEUS may prove useful for the differential diagnosis of IBD and colon cancer, but more studies are required.
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Affiliation(s)
- Fan Zhang
- Department of Ultrasound, Peking University Third Hospital, Haidian District, Beijing, China
| | - Li-Ying Miao
- Department of Ultrasound, Peking University Third Hospital, Haidian District, Beijing, China
| | - Hui-Yu Ge
- Department of Ultrasound, Peking University Third Hospital, Haidian District, Beijing, China.
| | - Shi Tan
- Department of Ultrasound, Peking University Third Hospital, Haidian District, Beijing, China
| | - Zhi-Qiang Li
- Department of Ultrasound, Peking University Third Hospital, Haidian District, Beijing, China
| | - Bo Zhao
- Department of Ultrasound, Peking University Third Hospital, Haidian District, Beijing, China
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Kniess T, Laube M, Wüst F, Pietzsch J. Technetium-99m based small molecule radiopharmaceuticals and radiotracers targeting inflammation and infection. Dalton Trans 2017; 46:14435-14451. [DOI: 10.1039/c7dt01735a] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
99mTc-labeled antibiotics, antifungal drugs, antimicrobial peptides and COX-2 inhibitors are comprehensively reviewed.
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Affiliation(s)
- Torsten Kniess
- Helmholtz-Zentrum Dresden-Rossendorf
- Institute of Radiopharmaceutical Cancer Research
- 01328 Dresden
- Germany
| | - Markus Laube
- Helmholtz-Zentrum Dresden-Rossendorf
- Institute of Radiopharmaceutical Cancer Research
- 01328 Dresden
- Germany
| | - Frank Wüst
- University of Alberta
- Department of Oncology
- 11560 University Avenue
- Edmonton
- Canada
| | - Jens Pietzsch
- Helmholtz-Zentrum Dresden-Rossendorf
- Institute of Radiopharmaceutical Cancer Research
- 01328 Dresden
- Germany
- Technische Universität Dresden
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The Current Role of Radiologic and Endoscopic Imaging in the Diagnosis and Follow-Up of Colonic Diverticular Disease. AJR Am J Roentgenol 2016; 207:15-24. [PMID: 27082846 DOI: 10.2214/ajr.16.16138] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Colonic diverticular disease is among the most prevalent conditions in Western society and is a common cause for outpatient visits and hospitalizations. The role of imaging is in evolution, but it has proven useful in confirming clinically suspected disease, assessing severity and complications, and directing patient management. CONCLUSION This review focuses on the current role of radiologic and endoscopic imaging in distinct clinical scenarios of diverticular disease, with emphasis on diverticulitis and its follow-up.
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Kannengiesser K, Mahlke R, Petersen F, Peters A, Ross M, Kucharzik T, Maaser C. Contrast-enhanced harmonic endoscopic ultrasound is able to discriminate benign submucosal lesions from gastrointestinal stromal tumors. Scand J Gastroenterol 2012; 47:1515-20. [PMID: 23148660 DOI: 10.3109/00365521.2012.729082] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although endoscopic ultrasound (EUS) has improved the diagnostic of potential malignancies, gastric lesions with suspicion of gastrointestinal stromal tumors (GIST) or benign lesions like lipoma or leiomyoma can often not be accurately differentiated by EUS, therefore, requiring tissue sampling with the risk of bleeding complications especially in GIST. As with the newest generation of EUS machines, contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) has become a new option to determine perfusion characteristics. The aim of this analysis was to evaluate whether CEH-EUS may help to discriminate various submucosal lesions. METHODS Data sets of 17 patients with suspicious gastric or esophageal lesions, who were investigated with CEH-EUS were analyzed. Perfusion characteristics were classified by the investigator immediately and statistically analyzed after investigation. Samples from EUS-fine needle aspirates, biopsy samples after needle cut or surgical specimen served as gold standard. RESULTS CEH-EUS showed nine lesions with reduced contrast enhancement (maximum intensity 6.2 ± 1.9 db) and eight lesions with hyperenhancement (47.3 ± 11.6 db). The latter eight lesions were all histologically identified as GIST, while the nine hypoenhanced lesions emerged to be four lipoma and five leiomyoma. Statistical analysis corresponded with initial perfusion classification in all cases. CONCLUSION This is the first study showing that CEH-EUS can discriminate GIST from benign lesions with good accuracy. In the future, CEH-EUS-guided discrimination may lead to individualized diagnostic and therapeutic strategies in handling submucosal lesions.
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Affiliation(s)
- Klaus Kannengiesser
- Department of General Internal Medicine and Gastroenterology, University Teaching Hospital Lueneburg, Lueneburg, Germany.
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Barreiros A, Galle P, Dietrich C, Ignee A. Neues zur Sonographie in der Gastroenterologie (Teil 1). DER GASTROENTEROLOGE 2012; 7:340-346. [DOI: 10.1007/s11377-012-0677-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
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Antonelli E, Giuliano V, Casella G, Villanacci V, Baldini V, Baldoni M, Morelli O, Bassotti G. Ultrasonographic assessment of colonic wall in moderate-severe ulcerative colitis: comparison with endoscopic findings. Dig Liver Dis 2011; 43:703-6. [PMID: 21482208 DOI: 10.1016/j.dld.2011.02.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 01/17/2011] [Accepted: 02/24/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND Bowel ultrasound has been shown to be a useful tool to evaluate patients with inflammatory bowel disease, especially Crohn's disease. However, such data are still scarce in ulcerative colitis patients. AIMS To establish the value of bowel ultrasound in moderate to severe ulcerative colitis patients, and compare these data with endoscopic findings. PATIENTS AND METHODS Endoscopic, ultrasound and C-reactive protein data from 51 patients with moderate to severe ulcerative colitis observed during a 3-year period were retrospectively obtained and analysed. RESULTS All patients displayed pathological thickness (>4 mm) of the colon wall. This value strongly correlated with C-reactive protein values (p=0.0001) and the endoscopic score (p<0.0001). Also, a strong correlation (p<0.0001) was found between CRP values and endoscopic score. CONCLUSIONS Bowel ultrasound, in expert hands, may represent a useful adjunctive (or first line) tool for the evaluation of patients with moderate to severe ulcerative colitis.
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Affiliation(s)
- Elisabetta Antonelli
- Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, Italy
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