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Quantitative contrast-enhanced ultrasound for monitoring vedolizumab therapy in inflammatory bowel disease patients: a pilot study

机译:用于监测炎症性肠病患者的vedolizumab治疗的定量对比增强超声:试点研究

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Background Microvascularization of the bowel wall can be visualized and quantified non-invasively by software-assisted analysis of derived time-intensity curves. Purpose To perform software-based quantification of bowel wall perfusion using quantitative contrast-enhanced ultrasound (CEUS) according to clinical response in patients with inflammatory bowel disease treated with vedolizumab. Material and Methods In a prospective study, in 18 out of 34 patients, high-frequency ultrasound of bowel wall thickness using color Doppler flow combined with CEUS was performed at baseline and after 14 weeks of treatment with vedolizumab. Clinical activity scores at week 14 were used to differentiate between responders and non-responders. CEUS parameters were calculated by software analysis of the video loops. Results Nine of 18 patients (11 with Crohn’s disease and seven with ulcerative colitis) showed response to treatment with vedolizumab. Overall, the responder group showed a significant decrease in the semi-quantitative color Doppler vascularization score. Amplitude-derived CEUS parameters of mural microvascularization such as peak enhancement or wash-in rate decreased in responders, in contrast with non-responders. Time-derived parameters remained stable or increased during treatment in all patients. Conclusion Analysis of bowel microvascularization by CEUS shows statistically significant changes in the wash-in-rate related to response of vedolizumab therapy.
机译:背景技术通过衍生的时间强度曲线的软件辅助分析,可以通过软件辅助分析来可视化和量化肠壁的微血管。目的通过用Vedolizuab处理的炎症性肠病患者的临床反应,使用定量对比增强超声(CEUS)进行基于软件的肠壁灌注的量化。在前瞻性研究中的材料和方法,在34例中,使用彩色多普勒流的肠壁厚度与Ceus的高频超声在基线和vedolizumab治疗14周后进行。第14周的临床活动分数用于区分响应者和非响应者。通过视频环路的软件分析计算CEUS参数。结果18名患者(11例患有克罗恩病和溃疡性结肠炎)的九个患者显示出对vedolizumab治疗的反应。总体而言,响应者组显示出半定量颜色多普勒血管化评分的显着降低。与非响应者相比,镜像微血管或镜像微血管或诸如峰值增强或洗涤速率下降的振幅衍生的Ceus参数减少。在所有患者的治疗过程中,时间衍生的参数保持稳定或增加。结论CEUS的肠道微血管化分析显示与vedolizumab疗法响应相关的统计学上显着的变化。

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