Ultrasound Shear Wave Elastography and Contrast Enhancement

Lu, Cathy; Gui, Xianyong; Chen, Wenqian; Fung, Tak; Novak, Kerri L.; Wilson, Stephanie R.

doi:10.1097/mib.0000000000001020

Cited by 80 publications

(55 citation statements)

References 42 publications

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“…There exists no standardization of measuring bowel wall by ARFI. The significance of obesity, inter-/intra-observer reliability (depending on experience), and applicability of an ARFI quality parameter (interquartile range/median > 0.30) is unknown (21). A possible influence of disease duration (with unknown balance of normal, inflammatory, or even fibrotic components within the bowel wall) or concomitant medical drugs on ARFI elastography in UC is unclear.…”

Section: Discussionmentioning

confidence: 99%

Acoustic radiation force impulse (ARFI) shear wave elastography of the bowel wall in healthy volunteers and in ulcerative colitis

Goertz

Lueke

Schellhaas

et al. 2019

Acta Radiologica Open

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Background: Acoustic radiation force impulse (ARFI) elastography is a non-invasive, ultrasound-based approach of evaluation of tissue elasticity. It has not yet been systematically applied to the bowel wall. Purpose: To perform ARFI elastography of the bowel wall in healthy volunteers and patients with ulcerative colitis (UC). Material and Methods: A high-frequency ultrasound (with bowel wall thickness and vascularization score) and an ARFI elastography of the bowel wall were performed in 20 patients with UC and 13 healthy volunteers. At least 10 ARFI measurements were obtained within the terminal ileum and the ascending, transverse, descending, and sigmoid colon and correlated with results of high-frequency ultrasound. Results: The UC group had mostly moderate disease activity. All patients had signs of inflammation upon B-mode ultrasound. Eight patients showed an ulcerative (ileo)pancolitis. Overall, ARFI elastography values and wall thickness were higher in the UC group than in the group of healthy volunteers (P ¼ 0.021 and P < 0.001, respectively). ARFI velocities of the separate segments were significantly higher in the transverse (P ¼ 0.045) and sigmoid colon (P ¼ 0.032) in case of UC. Conclusion: ARFI elastography of the bowel wall of the colonic frame and the terminal ileum is feasible but shows high standard deviation. ARFI shear wave velocities appear to be slightly higher in patients with UC than in healthy volunteers, particularly in the sigmoid and transverse colon. Further studies are needed.

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Section: Discussionmentioning

confidence: 99%

Acoustic radiation force impulse (ARFI) shear wave elastography of the bowel wall in healthy volunteers and in ulcerative colitis

Goertz

Lueke

Schellhaas

et al. 2019

Acta Radiologica Open

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“…Nonetheless, the study was a step toward demonstrating the applicability of SWE in clinical practice, as only 10 out of 105 patients were excluded due to high interquartile range of their individual measurements. 14 …”

Section: Futurementioning

confidence: 99%

Advanced imaging techniques for small bowel Crohn’s disease: what does the future hold?

Pita

Magro

2018

Therap Adv Gastroenterol

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Treatment of Crohn’s disease (CD) is intrinsically reliant on imaging techniques, due to the preponderance of small bowel disease and its transmural pattern of inflammation. Ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) are the most widely employed imaging methods and have excellent diagnostic accuracy in most instances. Some limitations persist, perhaps the most clinically relevant being the distinction between inflammatory and fibrotic strictures. In this regard, several methodologies have recently been tested in animal models and human patients, namely US strain elastography, shear wave elastography, contrast-enhanced US, magnetization transfer MRI and contrast dynamics in standard MRI. Technical advances in each of the imaging methods may expand their indications. The addition of oral contrast to abdominal US appears to substantially improve its diagnostic capabilities compared to standard US. Ionizing dose-reduction methods in CT can decrease concern about cumulative radiation exposure in CD patients and diffusion-weighted MRI may reduce the need for gadolinium contrast. Clinical indexes of disease activity and severity are also increasingly relying on imaging scores, such as the recently developed Lémann Index. In this review we summarize some of the recent advances in small bowel CD imaging and how they might affect clinical practice in the near future.

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“…Differentiation of these two broad categories is recognized as a major role for imaging techniques as management differs. Several investigators have addressed the role of CEUS [ 40 – 42 ] and also elastography to characterize these strictures with ultrasound [ 42 , 43 ]. Our own study shows that, in patients with chronic stenotic disease, smooth muscle hyperplasia/hypertrophy may contribute more to stricture than fibrosis [ 44 ] similar that to prior study by Baumgart [ 45 ].…”

Section: Indications For Ceus Of the Bowelmentioning

confidence: 99%

Role of contrast-enhanced ultrasound in evaluation of the bowel

2017

Self Cite

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Contrast-enhanced ultrasound (CEUS) of the gastrointestinal tract provides vascular information helpful for characterizing masses and other pathologies in and around the bowel, similar to contrast applications in other solid organs. However, the use of microbubble contrast agents for the bowel provides additional unique contributions as it gives both subjective and objective information about mural and mesenteric blood flow, invaluable for the determination of disease activity in those many patients affected by inflammatory bowel disease (IBD). IBD is a lifelong chronic disease and has its peak age of onset in adolescence or young adult life. Today, we have moved away from treating patient’s symptoms and strive instead to alter the course of disease by obtaining mucosal healing. Expensive and aggressive biologic therapies and lack of agreement of patient’s symptoms with their disease activity and complications necessitate frequent imaging surveillance, which must be safe, readily available, inexpensive, and effective. Ultrasound with the benefit of contrast enhancement meets these requirements and is shown in meta-analysis to be equivalent to CT and MRI scans for these indications.Electronic supplementary materialThe online version of this article (10.1007/s00261-017-1399-6) contains supplementary material, which is available to authorized users.

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Ultrasound Shear Wave Elastography and Contrast Enhancement

Cited by 80 publications

References 42 publications

Acoustic radiation force impulse (ARFI) shear wave elastography of the bowel wall in healthy volunteers and in ulcerative colitis

Acoustic radiation force impulse (ARFI) shear wave elastography of the bowel wall in healthy volunteers and in ulcerative colitis

Advanced imaging techniques for small bowel Crohn’s disease: what does the future hold?

Role of contrast-enhanced ultrasound in evaluation of the bowel

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