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Crohn Disease: HELP
Articles by Jonathan M. Rubin
Based on 5 articles published since 2010
(Why 5 articles?)

Between 2010 and 2020, Jonathan M. Rubin wrote the following 5 articles about Crohn Disease.
+ Citations + Abstracts
1 Article Can Contrast-Enhanced Sonography Detect Bowel Wall Fibrosis in Mixed Inflammatory and Fibrotic Crohn Disease Lesions in an Animal Model? 2017

Dillman, Jonathan R / Rubin, Jonathan M / Johnson, Laura A / Moons, David S / Higgins, Peter D R. ·Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. · Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA. · Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA. · Department of Pathology, University of Michigan Health System, Ann Arbor, Michigan, USA. ·J Ultrasound Med · Pubmed #28072481.

ABSTRACT: OBJECTIVES: To determine whether contrast-enhanced sonographic quantitative perfusion parameters can detect bowel wall fibrosis in the setting of mixed inflammatory and fibrotic lesions in a Crohn disease animal model. METHODS: This study was approved by the institutional Committee on the Use and Care of Animals. Multiple (range, 1-5) 2,4,6-trinitrobenzenesulfonic acid-ethanol enemas were used to create intestinal inflammatory lesions with variable fibrosis in female Lewis rats. Low-mechanical index contrast-enhanced sonography was performed 3 days after the final enema using a 0.2-mL bolus of sulfur hexafluoride microbubbles injected through a tail vein. Contrast-enhanced sonographic data were analyzed with software that converts video data into echo-power (linearized) data. Colorectal lesions were scored for histopathologic inflammation and fibrosis; bowel wall collagen was quantified by Western blotting. The Spearman correlation was used to assess associations between contrast-enhanced sonographic quantitative parameters and bowel wall collagen; the Kruskal-Wallis test was used to compare continuous results between histopathologic groups. RESULTS: Thirty-one animals were included in our analysis. Animals were placed into 3 histopathologic cohorts: (1) severe bowel wall inflammation/minimal or no fibrosis (n = 11); (2) severe bowel wall inflammation/moderate fibrosis (n = 9); and (3) severe bowel wall inflammation/severe fibrosis (n = 11). Western blotting showed a significant difference in bowel wall collagen between histopathologic cohorts (P = .0001). There was no correlation between any contrast-enhanced sonographic quantitative parameter and bowel wall collagen (P > .05). There was no difference between histopathologic cohorts for any contrast-enhanced sonographic quantitative parameter (P > .05). CONCLUSIONS: Contrast-enhanced sonographic quantitative perfusion parameters failed to effectively detect bowel wall fibrosis in the setting of superimposed inflammation in a Crohn disease animal model.

2 Article Ultrasound shear wave elastography helps discriminate low-grade from high-grade bowel wall fibrosis in ex vivo human intestinal specimens. 2014

Dillman, Jonathan R / Stidham, Ryan W / Higgins, Peter D R / Moons, David S / Johnson, Laura A / Keshavarzi, Nahid R / Rubin, Jonathan M. ·Departments of Radiology (J.R.D., J.M.R.), Internal Medicine, Division of Gastroenterology (R.W.S., P.D.R.H., L.A.J.), and Pathology (D.S.M.), University of Michigan Health System, Ann Arbor, Michigan USA · and Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, Michigan USA (N.R.K.). ·J Ultrasound Med · Pubmed #25425367.

ABSTRACT: OBJECTIVES: To determine whether bowel wall fibrosis can be detected in freshly resected human intestinal specimens based on ultrasound-derived shear wave speed. METHODS: Seventeen intact (>3-cm) bowel segments (15 small and 2 large intestine) from 12 patients with known or suspected inflammatory bowel disease were procured immediately after surgical resection. Ultrasound shear wave elastography of the bowel wall was performed by two methods (Virtual Touch Quantification [VTQ] and Virtual Touch-IQ [VT-IQ]; Siemens Medical Solutions USA, Inc, Mountain View, CA). Eighteen short-axis shear wave speed measurements were acquired from each specimen: 3 from the 9-, 12-, and 3-o'clock locations for each method. Imaging was performed in two areas for specimens greater than 10 cm in length (separated by ≥5 cm). A gastrointestinal pathologist scored correlative histologic slides for inflammation and fibrosis. Differences in mean shear wave speed between bowel segments with low and high inflammation/fibrosis scores were assessed by a Student t test. Receiver operating characteristic curve analysis was performed. RESULTS: High-fibrosis score (n = 11) bowel segments had a significantly greater mean shear wave speed than low-fibrosis score (n = 6) bowel segments (mean ± SD: VTQ, 1.59 ± 0.37 versus 1.18 ± 0.08 m/s; P= .004; VT-IQ, 1.87 ± 0.44 versus 1.50 ± 0.26 m/s; P= .049). There was no significant difference in mean shear wave speed between high-and low-inflammation score bowel segments (P > .05 for both VTQ and VT-IQ). Receiver operating characteristic curves showed areas under the curve of 0.91 (95% confidence interval, 0.67-0.99) for VTQ and 0.77 (95% confidence interval, 0.51-0.94) for VT-IQ in distinguishing low-from high-fibrosis score bowel segments. CONCLUSIONS: Ex vivo bowel wall shear wave speed measurements increase when transmural intestinal fibrosis is present.

3 Article US elastography-derived shear wave velocity helps distinguish acutely inflamed from fibrotic bowel in a Crohn disease animal model. 2013

Dillman, Jonathan R / Stidham, Ryan W / Higgins, Peter D R / Moons, David S / Johnson, Laura A / Rubin, Jonathan M. ·Department of Radiology, Section of Pediatric Radiology, University of Michigan Health System, C.S. Mott Children's Hospital, 1540 E Hospital Dr, Ann Arbor, MI 48109-4252, USA. jonadill@med.umich.edu ·Radiology · Pubmed #23401585.

ABSTRACT: PURPOSE: To determine if acoustic radiation force impulse elastography-derived bowel wall shear wave velocity (SWV) allows distinction of acutely inflamed from fibrotic intestine in a Crohn disease animal model. MATERIALS AND METHODS: University Committee on the Use and Care of Animals approval was obtained. An acute inflammation Crohn disease model was produced by treating eight Lewis rats with a single administration of trinitrobenzenesulfonic acid (TNBS) enema, with imaging performed 2 days later in the surviving six rats. Colonic fibrosis in an additional eight Lewis rats was achieved by administering repeated TNBS enemas during 4 weeks, with imaging performed in the surviving seven rats 7 days later to allow acute inflammation resolution. Nine transcutaneous bowel wall SWV measurements were obtained from the colon in all rats without and with applied strain. Mean SWVs without and with applied strain were compared between animal cohorts by using the Student t test, and receiver operating characteristic (ROC) curves were created to assess diagnostic performance. RESULTS: Mean bowel wall SWVs were significantly higher for fibrotic versus acute inflammation cohort of rats at 0% (3.4 ± 1.1 vs 2.3 ± 0.5 m/sec; P = .047) and 30% (6.3 ± 2.2 vs 3.6 ± 0.9 m/sec; P = .02) applied strain. Both acute inflammation and fibrotic cohort of rats demonstrated linear increases in mean SWV with increasing applied strain, with significantly different mean slopes (P = .02) and y-intercepts (P = .02). The area under the ROC curve of the SWV ratio (mean SWV/applied strain) for differentiating histopathologically confirmed fibrotic from inflamed bowel was 0.971. CONCLUSION: Bowel wall SWV helps distinguish acutely inflamed from fibrotic intestine in a Crohn disease animal model.

4 Article A new nonlinear parameter in the developed strain-to-applied strain of the soft tissues and its application in ultrasound elasticity imaging. 2012

Xu, Jingping / Tripathy, Sakya / Rubin, Jonathan M / Stidham, Ryan W / Johnson, Laura A / Higgins, Peter D R / Kim, Kang. ·Center for Ultrasound Molecular Imaging and Therapeutics, University of Pittsburgh and University of Pittsburgh Medical Center, Pittsburgh, PA, USA. ·Ultrasound Med Biol · Pubmed #22266232.

ABSTRACT: Strain developed under quasi-static deformation has been mostly used in ultrasound elasticity imaging (UEI) to determine the stiffness change of tissues. However, the strain measure in UEI is often less sensitive to a subtle change of stiffness. This is particularly true for Crohn's disease where we have applied strain imaging to the differentiation of acutely inflamed bowel from chronically fibrotic bowel. In this study, a new nonlinear elastic parameter of the soft tissues is proposed to overcome this limit. The purpose of this study is to evaluate the newly proposed method and demonstrate its feasibility in the UEI. A nonlinear characteristic of soft tissues over a relatively large dynamic range of strain was investigated. A simplified tissue model based on a finite element (FE) analysis was integrated with a laboratory developed ultrasound radio-frequency (RF) signal synthesis program. Two-dimensional speckle tracking was applied to this model to simulate the nonlinear behavior of the strain developed in a target inclusion over the applied average strain to the surrounding tissues. A nonlinear empirical equation was formulated and optimized to best match the developed strain-to-applied strain relation obtained from the FE simulation. The proposed nonlinear equation was applied to in vivo measurements and nonlinear parameters were further empirically optimized. For an animal model, acute and chronic inflammatory bowel disease was induced in Lewis rats with trinitrobenzene sulfonic acid (TNBS)-ethanol treatments. After UEI, histopathology and direct mechanical measurements were performed on the excised tissues. The extracted nonlinear parameter from the developed strain-to-applied strain relation differentiated the three different tissue types with 1.96 ± 0.12 for normal, 1.50 ± 0.09 for the acutely inflamed and 1.03 ± 0.08 for the chronically fibrotic tissue. T-tests determined that the nonlinear parameters between normal, acutely inflamed and fibrotic tissue types were statistically significantly different (normal/ fibrotic [p = 0.0000185], normal/acutely inflamed [p = 0.0013] and fibrotic/acutely inflamed [p = 0.0029]). This technique may provide a sensitive and robust tool to assess subtle stiffness changes in tissues such as in acutely inflamed bowel wall.

5 Article Ultrasound elasticity imaging for detecting intestinal fibrosis and inflammation in rats and humans with Crohn's disease. 2011

Stidham, Ryan W / Xu, Jingping / Johnson, Laura A / Kim, Kang / Moons, David S / McKenna, Barbara J / Rubin, Jonathan M / Higgins, Peter D R. ·Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA. ·Gastroenterology · Pubmed #21784048.

ABSTRACT: BACKGROUND: Intestinal fibrosis causes many complications of Crohn's disease (CD). Available biomarkers and imaging modalities lack sufficient accuracy to distinguish intestinal inflammation from fibrosis. Transcutaneous ultrasound elasticity imaging (UEI) is a promising, noninvasive approach for measuring tissue mechanical properties. We hypothesized that UEI could differentiate inflammatory from fibrotic bowel wall changes in both animal models of colitis and humans with CD. METHODS: Female Lewis rats underwent weekly trinitrobenzene sulfonic acid enemas yielding models of acute inflammatory colitis (n = 5) and chronic intestinal fibrosis (n = 6). UEI scanning used a novel speckle-tracking algorithm to estimate tissue strain. Resected bowel segments were evaluated for evidence of inflammation and fibrosis. Seven consecutive patients with stenotic CD were studied with UEI and their resected stenotic and normal bowel segments were evaluated by ex vivo elastometry and histopathology. RESULTS: Transcutaneous UEI normalized strain was able to differentiate acutely inflamed (-2.07) versus chronic fibrotic (-1.10) colon in rat models of inflammatory bowel disease (IBD; P = .037). Transcutaneous UEI normalized strain also differentiated stenotic (-0.87) versus adjacent normal small bowel (-1.99) in human CD (P = .0008), and this measurement also correlated well with ex vivo elastometry (r = -0.81). CONCLUSIONS: UEI can differentiate inflammatory from fibrotic intestine in rat models of IBD and can differentiate between fibrotic and unaffected intestine in a pilot study in humans with CD. UEI represents a novel technology with potential to become a new objective measure of progression of intestinal fibrosis. Prospective clinical studies in CD are needed.