title: Use of color Doppler ultrasonography for evaluating vascularity of small intestinal lesions in Crohn's disease: correlation with endoscopic and surgical macroscopic findings.
abstract: OBJECTIVE. Ultrasonography (US) is a simple, inexpensive and minimally invasive method. We evaluated the vascularity of small intestinal lesions in Crohn's disease using color Doppler US (CD-US) and retrospectively compared them with endoscopic and surgical macroscopic findings. MATERIAL AND METHODS. In order to compare CD-US and endoscopic findings, 108 Crohn's disease patients who underwent examination of the terminal ileum by both colonoscopy and CD-US were included in the study. Vascularity was evaluated in CD-US using a semiquantitative method, the Limberg score. We analyzed correlations between Limberg score and simple endoscopic score for Crohn's disease (SES-CD), an index reflecting endoscopic activity. Scores of SES-CD 3 and higher were defined as endoscopically active. For comparison with surgical macroscopic findings, 22 Crohn's disease patients who received CD-US and subsequent iliectomies were included. Lesions with apparent open ulcers were defined as active, and those without as non-active. These findings were compared with the Limberg score. RESULTS. A substantial positive correlation was observed between Limberg scores and SES-CD (ρ = 0.709 [p < 0.001]). Notably, all 27 cases with a Limberg score of 3 or 4 were classified as endoscopically active. Compared to surgical macroscopic activity, Limberg scores of active lesions were significantly higher than those of non-active lesions (p = 0.005). In particular, all 11 cases with a Limberg score of 3 or 4 were classified as active lesions. CONCLUSION. Vascularity of small intestinal lesions of Crohn's disease evaluated by CD-US with Limberg score is well correlated with endoscopic and surgical macroscopic findings.
authors.affiliation: Gastroenterological Center, Yokohama City University Medical Center , Yokohama , Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Sasaki
authors.forename: Reiko
authors.initials: R
authors.lastname: Kunisaki
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Hisae
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kimura
authors.forename: Akiho
authors.initials: A
authors.lastname: Hanzawa
authors.forename: Naomi
authors.initials: N
authors.lastname: Shibata
authors.forename: Hiromi
authors.initials: H
authors.lastname: Yonezawa
authors.forename: Eiji
authors.initials: E
authors.lastname: Miyajima
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sakamaki
authors.forename: Kazushi
authors.initials: K
authors.lastname: Numata
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shin
authors.initials: S
authors.lastname: Maeda
mesh_terms: D000328:Adult; D003113:Colonoscopy; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color