Differentiation of Inflammatory from Fibrotic Ileal Strictures Among Patients with Crohn’s Disease through Analysis of Time-intensity Curves Obtained after Microbubble Contrast Agent Injection

The aim was to assess whether the analysis of time-intensity curves obtained after microbubble contrast agent injection could differentiate inflammatory from fibrotic ileal strictures among patients with Crohn’s disease (CD). Sixty-five consecutive patients (40 male and 25 female; mean age ± SD, 42.2 years ± 12.22) with stricture of the terminal ileal loop from CD were scanned after microbubble injection. Time-intensity curves were obtained from quantitative analysis and peak enhancement, rise time, time to peak, area under the time-intensity curve (AUC), AUC during wash-in (AUCWI), and AUC during wash-out (AUCWO) were compared between patients with inflammatory vs patients with fibrotic strictures. Inflammatory (n=40) vs fibrotic strictures (n=25) differed (P<.05) in the peak enhancement, the wash-in rate, the wash-in perfusion index, AUC, AUCWI, AUCWO. The quantitative analysis of small bowel wall contrast enhancement after microbubble contrast agent injection may differentiate inflammatory from fibrotic ileal strictures in patients with CD.