Case of the Day: Rule out Inflammatory Bowel Disease

Teaching Point - Greyscale image of classic IBD

Although both Wall thickening and inflammatory fat increase in direct proportion to inflammation, Wall thickening is the most commonly associated with active inflammatory disease.

Teaching Point:

There is no signal on Color Doppler Imaging, making the presence of activity indeterminate. As well as active inflammation, Wall thickening especially may be present in chronic fibrotic disease

Teaching Point:

Blood flow at the perfusion level is easily recognized on CEUS and is a reflection of active inflammation. It resolves indeterminate results on greyscale and Color Doppler scan.

Teaching Point:

The Intensity of CEUS perfusion can be analyzed not only subjectively, but objectively These parameters of 27dB and 8830 linearsec are indicative of severe active inflammation in spite of the absence of color signal.
With the addition of CEUS and subsequent quantitative analysis to assess enhancement, the subjective nature of ultrasound is reduced and an accurate and subtle comparison can be made between exams and patients