Journal Mobile Options
Table of Contents
Vol. 22, No. 1, 2004
Issue release date: 2004

Doppler Sonography in the Diagnosis of Inflammatory Bowel Disease

Di Sabatino A. · Armellini E. · Corazza G.R.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Over the past few years, thanks to its ability to reveal neovascularization and inflammatory hyperemia, Doppler sonography has proved to be a valuable method for the assessment of disease activity in inflammatory bowel disease. Hypervascularization has been detected by Doppler imaging both in splanchnic vessels, in terms of flow volume and velocity, or resistance and pulsatility index on spectral analysis, and in small vessels of the affected bowel wall in terms of vessel density. In particular, power Doppler has been shown to be a highly sensitive method for evaluating the presence of flow in vessels that are poorly imaged by conventional color Doppler, and in detecting internal fistulas complicating Crohn’s disease. Recently, the use of ultrasound contrast agents, such as Levovist, has been shown to improve the image quality of color Doppler by increasing the backscattered echoes from the desired regions, thus making it possible to better monitor the response to treatment and discriminate between active inflammatory and fibrotic bowel wall thickness in Crohn’s disease. Additionally, Levovist-enhanced power Doppler sonography has proved to be highly sensitive and specific in the detection of inflammatory abdominal masses associated with Crohn’s disease. In clinical practice, used in combination with second harmonic imaging and new generations of stable contrast agents, Doppler sonography appears to be a non-invasive and effective diagnostic tool in the diagnosis and follow-up of Crohn’s disease and ulcerative colitis.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Maconi G, Parente F, Bollani S, Cesana B, Bianchi Porro G: Abdominal ultrasound in the assessment of extent and activity of Crohn’s disease: Clinical significance and implication of bowel wall thickening. Am J Gastroenterol 1996;91:1604–1609.
  2. Wakefield AJ, Sankey EA, Dhillon AP, Sawyerr AM, More L, Sim R, Pittilo RM, Rowles PM, Hudson M, Lewis AA: Granulomatous vasculitis in Crohn’s disease. Gastroenterology 1991;100:1279–1287.
  3. Brahme F, Lindstrom C: A comparative radiographic and pathological study of intestinal vasoarchitecture in Crohn’s disease and ulcerative colitis. Gut 1970;11:928–940.
  4. Eriksson U, Fagerberg S, Krausse U, Olding L: Angiographic studies in Crohn’s disease and ulcerative colitis. Am J Roentgenol Radium Ther Nucl Med 1970;110:385–392.
  5. Bolondi L, Gaiani S, Brignola C, Campieri M, Rigamonti A, Zironi G, Gionchetti P, Belloli C, Miglioli M, Barbara L: Changes in splanchnic hemodynamics in inflammatory bowel disease. Scand J Gastroenterol 1992;27:501–507.
  6. Maconi G, Imbesi V, Bianchi Porro G: Doppler ultrasound measurement of intestinal blood flow in inflammatory bowel disease. Scand J Gastroenterol 1996;31:590–593.
  7. Mirk P, Palazzoni G, Gimondo P: Doppler sonography of hemodynamic changes of the inferior mesenteric artery in inflammatory bowel disease: Preliminary data. AJR 1999;173:381–387.
  8. Van Oostayen JA, Wasser MNJM, van Hogezand RA, Griffioen G, de Roos A: Activity of Crohn’s disease assessed by measurement of superior mesenteric artery flow with Doppler US. Radiology 1994;193:551–554.
  9. Van Oostayen JA, Wasser MNJM, Griffioen G, van Hogezand RA, Lamers CBHW, de Roos A: Diagnosis of Crohn’s ileitis and monitoring of disease activity: Value of Doppler ultrasound of superior mesenteric artery flow. Am J Gastroenterol 1998;93:88–91.
  10. Ludwig D, Wiener S, Brüning A, Schwarting K, Jantschek, Fellermann K, Stahl M, Stange EF: Mesenteric blood flow is related to disease activity and risk of relapse in ulcerative colitis: A prospective follow-up study. Gut 1999;45:546–552.
  11. Maconi G, Parente F, Bollani S, Imbesi V, Ardizzone S, Russo A, Bianchi Porro G: Factors affecting splanchnic haemodynamics in Crohn’s disease: A prospective controlled study using Doppler ultrasound. Gut 1998;43:645–650.
  12. Spalinger J, Patriquin H, Miron MC, Marx G, Herzog D, Dubois J, Dubinsky M, Seidman EG: Doppler US in patients with Crohn’s disease: Vessel density in the diseased bowel reflects disease activity. Radiology 2000;217:787–791.
  13. Ruess L, Nussbaum Blask AR, Bulas DI, Mohan P, Bader A, Latimer JS, Kerzner B: Inflammatory bowel disease in children and young adults: correlation of sonographic and clinical parameters during treatment. AJR 2000;175:79–84.
  14. Esteban JM, Maldonado L, Sanchiz V, Minguez M, Benages A: Activity of Crohn’s disease assessed by colour Doppler ultrasound analysis of the affected loops. Eur Radiol 2001;11:1423–1428.
  15. Clautice-Engle T, Jeffrey RB Jr, Li KC, Barth RA: Power Doppler imaging of focal lesion of the gastrointestinal tract: Comparison with conventional color Doppler imaging. J Ultrasound Med 1996;15:63–66.
  16. Di Sabatino A, Fulle I, Ciccocioppo R, Ricevuti L, Tinozzi FP, Tinozzi S, Campani R, Corazza GR: Doppler enhancement after intravenous Levovist injection in Crohn’s disease. Inflamm Bowel Dis 2002;8:251–257.
  17. Schlief R: Galactose-based echo-enhancing agents; in Goldberg BB (ed): Ultrasound Contrast Agents. London, Dunitz, 1997, pp 75–82.
  18. Blomley MJK, Cosgrove DO: Microbubble echo-enhancers: A new direction for ultrasound? Lancet 1997;349:1855–1856.
  19. Goldberg BB, Liu JB, Burns PN, Merton DA, Forsberg F: Galactose-based intravenous sonographic contrast agent: Experimental studies. J Ultrasound Med 1993;12:463–470.
  20. Kornbluth A, Salomon P, Sachar DB: Crohn’s disease; in Sleisenger MH, Fordtran JS (eds): Gastrointestinal Disease: Pathophysiology, Diagnosis and Management. Philadelphia, Saunders, 1993, pp 1270–1304.
  21. Angerson WJ, Allison MC, Baxter JN, Russell RI: Neoterminal ileal blood flow after ileocolonic resection for Crohn’s disease. Gut 1993;34:1531–1534.
  22. Esteban JM, Aleixandre A, Hurtado MJ, Maldonado L, Mora FJ, Nogues E: Contrast-enhanced power Doppler ultrasound in the diagnosis and follow-up of inflammatory abdominal masses in Crohn’s disease. Eur J Gastroenterol Hepatol 2003;15:253–259.
  23. Maconi G, Sampietro GM, Russo A, Bollani S, Cristaldi M, Parente F, Dottorini F, Bianchi Porro G: The vascularity of internal fistulae in Crohn’s disease: An in vivo power Doppler ultrasonography assessment. Gut 2002;50:496–500.
  24. Sandborn WJ, Hanauer SB: Infliximab in the treatment of Crohn’s disease: A user’s guide for clinicians. Am J Gastroenterol 2002;97:2962–2972.
  25. Fishman SJ, Feins NR, D’Amato RJ, Folkman J: Thalidomide therapy for Crohn’s disease. Gastroenterology 2000;119:596.
  26. Di Sabatino A, Ciccocioppo R, Cinque B, Benazzato L, Morera R, Cifone MG, Sturniolo GC, Corazza GR: Serum basic fibroblast growth factor and vascular endothelial growth factor in Crohn’s disease patients treated with infliximab. Dig Liver Dis 2002;34:A87.
  27. D’Amato RJ, Loughnan MS, Flynn E, Folkman J: Thalidomide is an inhibitor of angiogenesis. Proc Natl Acad Sci USA 1994;91:4082–4085.
  28. Bouakaz A, Krenning BJ, Vletter WB, ten Cate FJ, De Jong N: Contrast superharmonic imaging: A feasibility study. Ultrasound Med Biol 2003;29:547–553.
  29. Schneider M: SonoVue, a new ultrasound contrast agent. Eur Radiol 1999;9(suppl 3):347–348.


Pay-per-View Options
Direct payment This item at the regular price: USD 33.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 23.00