Doppler US in patients with crohn disease: vessel density in the diseased bowel reflects disease activity.
OBJECTIVE
To determine if neovascularization associated with Crohn disease, as detected with Doppler ultrasonography (US), reflects clinical disease activity.


METHODS
A devised measurement, vessel density, was estimated with color Doppler US. Patients with Crohn disease underwent clinical and laboratory assessment in which the Crohn disease activity index was measured; patients underwent abdominal US the same week. Color Doppler US was performed by using a 7.5-10.0- or 8.0-12.0-MHz transducer, the lowest possible pulse repetition frequency without aliasing, a low wall filter, and high Doppler gain settings. The length and thickness of the affected loops were measured, and the number of color Doppler signals per square centimeter in the bowel loop was counted. Pulsed Doppler US was used to confirm that the signals originated from arteries or veins and not from movement artifacts.


RESULTS
Ninety-two patients (aged 7-20 years; mean, 14.85 years; 44 female, 48 male) underwent 119 examinations; 85 were performed in patients with active disease. Affected loops were thicker (10.6 vs 4. 6 mm; P: <.001) and had a higher vessel density with disease (69 of 119 examinations) than during remission (two of 34 examinations; P: <.001).


CONCLUSIONS
Vessel density in affected bowel loops, as estimated with Doppler US, and bowel wall thickness (>5 mm) reflect disease activity in patients with Crohn disease.
Spalinger
J
J
Division of Pediatric Gastroenterology and Nutrition, Departments of Pediatrics, Hôpital Sainte-Justine, Université de Montréal, 3175 Côte-Sainte-Catherine, Montréal, Québec, Canada.
Patriquin
H
H
Miron
M C
MC
Marx
G
G
Herzog
D
D
Dubois
J
J
Dubinsky
M
M
Seidman
E G
EG
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007422:Intestines / Q000098:blood supply / Q000000981:diagnostic imaging*; D008297:Male; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D010865:Pilot Projects; D011446:Prospective Studies; D018615:Ultrasonography, Doppler, Color