Mesenteric Transit Time Using Contrast-Enhanced Ultrasound (CEUS) Does Not Correlate with Disease Activity in Crohn’s Disease

Abstract

Purpose: Evaluation of mesenteric transit time (MTT) – measured by contrast-enhanced ultrasound – as a marker for inflammatory activity in Crohn’s disease.

Materials and Methods: The time of maximum enhancement of the contrast agent in the superior mesenteric artery and vein was determined visually and by software analysis. The MTT was calculated as the difference between these two time points. Findings were correlated with the Harvey-Bradshaw Index (HBI) using the Pearson correlation coefficient (r). In addition, a healthy control group was evaluated both in the fasting state and 1, 2, 3 and 4 hours postprandially.

Results: In 20 healthy controls the mean visual MTT during fasting was 9.76 ± 2.83 sec and decreased to a minimum 1 hour after the meal (6.6 ± 2.27 sec). 45 patients with Crohn’s disease (9 males, 36 females, mean age 35 years) had a mean HBI of 5.9 ± 4.7 points. The mean software-based MTT of 9.76 ± 3.7 sec was significantly higher (p = 0.034) than the mean visual MTT of 8.22 ± 3.05 sec. The two figures correlated well (r = 0.72, p < 0.001). The HBI correlated neither with the visual (r = 0.14, p = 0.371) nor with the software-based (r = 0.16, p = 0.293) MTT.

Conclusion: The MTT decreases in the first two hours after eating. The visually assessed and the software-based MTT correlate well, however MTT does not correlate with disease activity in patients with Crohn‘s disease.

Zusammenfassung

Ziel: Korrelation der visuell und softwaregestützten mesenterialen Transitzeit (MTT) mit der klinischen Entzündungsaktivität bei Patienten mit Morbus Crohn.

Material und Methoden: Der Zeitpunkt des höchsten Enhancements eines Echosignalverstärkers in der Arteria mesenterica superior und Vena mesenterica superior wurde visuell während der Untersuchung sowie nach computergestützter Analyse des Videoloops bestimmt. Die MTT wurde als Differenz zwischen diesen beiden Zeitpunkten berechnet. Korrelationen zwischen den einzelnen Messwerten und dem Harvey-Bradshaw-Index (HBI) wurden mittels des Pearson-Korrelationskoeffizienten (r) überprüft. Darüber hinaus wurde eine gesunde Kontrollgruppe nüchtern und 1, 2, 3 und 4 Stunden postprandial untersucht.

Ergebnisse: Die 20 gesunden Probanden zeigten im Nüchternzustand eine mittlere visuelle MTT von 9,76 ± 2,83 s, die 1 Stunde postprandial auf minimal 6,6 ± 2,27 s sank. 45 Patienten (9 Männer, 36 Frauen, mittleres Alter 35 Jahre) mit histologisch nachgewiesenem Morbus Crohn hatten einen HBI von 5,9 ± 4,7 Punkten. Die mittlere softwarebasierte MTT bei Crohn-Patienten lag bei 9,76 ± 3,7 s und war deutlich länger (p = 0,034) als die mittlere visuelle MTT (8,22 ± 3,05 s). Die visuelle und softwarebasierte MTT korrelierten gut (r = 0,72; p < 0,001). Der Aktivitätsscore HBI korrelierte weder mit der visuell (r = 0,14; p = 0,371) noch mit der softwarequantifizierten MTT (r = 0,16; p = 0,293).

Schlussfolgerung: Die Nahrungsaufnahme verkürzt die MTT innerhalb der ersten zwei Stunden postprandial. Visuell bestimmte und softwarequantifizierte MTT korrelieren gut miteinander, jedoch nicht mit dem klinischen Aktivitätsscore bei Patienten mit Morbus Crohn.

Key words

CEUS - mesenteric transit time - Crohn’s disease - activity - quantification

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