Contrast-Enhanced Ultrasound and Shear Wave Elastography Evaluation of Crohn's Disease Activity in Three Adolescent Patients
10.5223/pghn.2019.22.3.282
- Author:
Matthew A THIMM
1
;
Carmen CUFFARI
;
Alejandro GARCIA
;
Sarah SIDHU
;
Misun HWANG
Author Information
1. The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Publication Type:Case Report
- Keywords:
Ultrasound;
Contrast agents;
Elastography;
Crohn's disease;
Inflammatory bowel disease;
Pediatrics
- MeSH:
Adolescent;
Anastomosis, Surgical;
Constriction, Pathologic;
Contrast Media;
Crohn Disease;
Elasticity Imaging Techniques;
Endoscopy;
Fibrosis;
Humans;
Inflammation;
Inflammatory Bowel Diseases;
Pathology, Surgical;
Pediatrics;
Ultrasonography
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2019;22(3):282-290
- CountryRepublic of Korea
- Language:English
-
Abstract:
Characterizing inflammation and fibrosis in Crohn's disease (CD) is necessary to guide clinical management, but distinguishing the two remains challenging. Novel ultrasound (US) techniques: contrast-enhanced US (CEUS) and shear wave elastography (SWE) offer great potential in evaluating disease activity in pediatric patients. Three patients ages 16 to 20 with known CD underwent CEUS and SWE to characterize bowel wall inflammation and fibrosis. Magnetic resonance enterography, endoscopy, or surgical pathology findings are also described when available. The patients' disease activity included acute inflammation, chronic inflammation with stricture formation, and a fibrotic surgical anastomosis without inflammation. CEUS was useful in determining the degree of inflammation, and SWE identified bowel wall fibrosis. Used together these techniques allow for better characterization of the degree of fibrosis and inflammation in bowel strictures. With further validation CEUS and SWE may allow for improved characterization of bowel strictures and disease flares in pediatric patients suffering from CD.
