Diagnosis of Crohn's ileitis and monitoring of disease activity: value of Doppler ultrasound of superior mesenteric artery flow

Abstract

Objective: To assess the value of measurements of superior mesenteric artery flow using Doppler ultrasound for detecting disease activity in patients with proven or suspected Crohn's disease. Methods: Superior mesenteric artery flow was measured prospectively in 31 patients with known or suspected small-bowel disease. Sixteen patients were known to suffer from Crohn's disease and were suspected of having active disease. Fifteen patients had abdominal complaints without a specific diagnosis. Enteroclysis was used as the standard of reference to detect Crohn's disease, to define the location of small-bowel Crohn's disease, and to assess disease activity by demonstrating cobblestoning. Disease activity was further substantiated by clinical signs, laboratory values, and clinical follow-up. Results: Ten patients with active disease on enteroclysis made up group 1. Group 2 comprised nine patients known to have Crohn's disease but without active disease (inactive small-bowel disease). The remaining 12 patients made up group 3. In group 1, the flow volume values were significantly higher than those in group 2 and group 3: 738 ± 411 (mean ± SD). versus 364 ± 101 and 300 ± 91, respectively ( p < 0.05). Conclusions: Whereas the initial diagnosis of small-bowel involvement in Crohn's disease may rely on enteroclysis, Doppler measurements of superior mesenteric artery flow are useful to monitor the activity of Crohn's disease.