B-mode ultrasound and dynamic contrast-enhanced ultrasound (DCE-US) of the bowel wall in patients with gastrointestinal food allergy in comparison to Crohn's disease and healthy controls

Abstract The aim of this study was to assess bowel wall thickness using B-mode ultrasound (US) and perfusion measurement by DCE-US in patients with a food allergy (FA) compared to healthy controls (HCs) and patients with active Crohn's disease (CD). Bowel wall thickness and perfusion were assessed in FA patients as well as in HCs on a potato rice diet (PRD) and after a provocation diet (PD). Additionally, patients with active CD were examined for further comparison. A total of 48 individuals (20 with FAs, 20 with CD, and 8 HCs) were included. There was no significant difference between the HCs and patients with FAs regarding the thickness of the terminal ileum (1.8mm vs. 2.2mm; p=0.46) and the sigmoid colon (2.1mm vs. 2.1mm; p=1) on a PRD. After a PD, the median value was significantly lower in the terminal ileum for HCs compared to patients with FAs (1.6 mm vs. 2.3 mm; p=0.03). In CD patients, the thickness of the terminal ileum was far more pronounced (median thickness 6 mm) compared to HCs and patients with FAs (p<0.001). There was no statistically significant difference for all tested DCE-US parameters in the terminal ileum between the HCs and patients with FAs on either PRD or PD. However, DCE-US perfusion parameters (PE, WiAUC, WiR, WiPi, and WoR) were significantly higher in patients with CD compared to HCs and patients with FAs on a PD. Assessment of wall thickening of the terminal ileum using US and perfusion measurements via DCE-US appears to be insufficient for distinguishing between HCs and patients with FAs. However, US and DCE-US could be helpful in differentiating patients with CD from those with FAs.