Dynamic Tissue Perfusion Measurement in the Intestinal Wall — Correlation With Ulcerative Colitis

Abstract

Chronic inflammatory bowel diseases are characterized by unpredictable exacerbations, which require an adaptation of medical treatment. The optimal dosage of anti-inflammatory drugs is often determined based on patient complaints. Children are often especially difficult to evaluate, since their complaints tend to be vague and require an independent evaluation by laboratory and endoscopic findings. Colonoscopy, however, cannot be repeated too often since it is invasive, requires sedation and raises the threshold for a precise diagnosis of actual disease activity. Dynamic tissue perfusion measurement is a non-invasive method of blood flow intensity evaluation, which has been successfully used to grade inflammatory activities in children with Crohn's disease. We investigated the correlation of histological findings in ulcerative colitis and local bowel wall perfusion in affected parts of the colon at the site of biopsy. We found a significant correlation between intestinal wall perfusion and the score of lymphocyte infiltration, crypt abscesses, neutrophil infiltration, as well as an inverse correlation with wall edema. Subjects included 12 pediatric patients with ulcerative colitis from whom biopsies were taken and analyzed. Dynamic tissue perfusion measurement is a useful and patient-friendly adjunct to the conventional diagnostic armamentarium, which reduces the use of colonoscopies.