溃疡性结肠炎
医学
内镜超声
超声波
对比度(视觉)
肿瘤坏死因子α
超声造影
放射科
胃肠病学
内科学
疾病
计算机科学
人工智能
作者
Mark Ellrichmann,B Schulte,Claudio C Conrad,Stephan Schoch,Johannes Bethge,Markus Seeger,Robert Huber,Madita Goeb,Alexander Arlt,Susanna Nikolaus,Christoph Röcken,Stefan Schreiber
出处
期刊:Journal of Crohn's and Colitis
[Oxford University Press]
日期:2024-03-08
标识
DOI:10.1093/ecco-jcc/jjae034
摘要
Abstract Background and Aim Though colonoscopy plays a crucial role in assessing active ulcerative colitis (aUC), its scope is limited to the mucosal surface. Endoscopic ultrasound (EUS) coupled with contrast-enhancement (dCEUS) can precisely quantify bowel wall thickness and microvascular circulation, potentially enabling the quantitative evaluation of inflammation. We conducted a prospective, longitudinal study to assess therapy response using dCEUS in aUC patients undergoing treatment with adalimumab (ADA) or infliximab (IFX). Methods 30 ADA- and 15 IFX-treated aUC patients were examined at baseline and at 2, 6, 14 weeks of therapy and 48 weeks of follow-up. Bowel wall thickness (BWT) was measured by EUS in the rectum. Vascularity was quantified by dCEUS using Rise Time (RT) and Time To Peak (TTP). Therapy response was defined after 14 weeks using the Mayo Score. Results Patients with aUC displayed a mean BWT of 3.9±0.9 mm. In case of response to ADA/IFX a significant reduction in BWT was observed after 2 weeks (p=0.04), whereas non-responders displayed no significant changes. The TTP was notably accelerated at baseline and significantly normalised by week 2 in responders (p=0.001), while non-responders exhibited no significant alterations (p=0.9). At week 2, the endoscopic Mayo score did not exhibit any changes, thus failing to predict treatment responses. Conclusion dCEUS enables the early detection of therapy response in patients with aUC, which serves as a predictive marker for long term clinical success. Therefore, dCEUS serves as a diagnostic tool for assessing the probability of future therapy success.
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