Abstract

real-time contrast-enhanced US (CEUS) with low-mechanical index, after the injection of 2.4ml of sulfur hexafluoride-filled microbubbles (SonoVue, Bracco, Milan, Italy). The vascularity of the terminal ileum was quantified by a dedicated software (Qontrast, Bracco, Milan Italy) and different kinetic parameters of vascular perfusion calculated. Inflammation, angiogenesis and endothelial function were evaluated by measuring VEGF, TNFalpha and NO. All measurements were performed before and 30 minutes after a standard caloric meal (Resource Energy Nestle, 300 Kcal). Statistical analysis was performed using Wilcoxon and Spearman’s rank correlation tests. Results: Basal and postprandial SH and CEUS parameters did not significantly differ between CD patients and controls, whilst resistance index of arteriolar bed, detectable only in CD patients, showed a significant reduction after meal. NO and TNF-alpha significantly reduced after meal only in CD patients. A significant correlation was found between CEUS parameters of vascular perfusion, and VEGF before the meal (r = 0.63 0.71; p < 0.05). Furthermore, we found a significant correlation between splanchnic blood flow and CEUS parameters of vascular perfusion during fasting (r = 0.66 0.79; p < 0.05), but not in the postprandial period. Conclusions: In ileal CD patients, splanchnic blood flow is correlated with vascular perfusion of the intestinal wall, which is related to VEGF and likely with angiogenesis. This is evident only during fasting, but not in the post-prandial period, where other vasoactive factors are probably involved.

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