Resistance index in mural arteries of thickened bowel wall: predictive value for Crohn disease activity assessment in pediatric patients

Wien Klin Wochenschr. 2013 May;125(9-10):254-60. doi: 10.1007/s00508-013-0357-8. Epub 2013 Apr 13.

Abstract

Objective: To define reliable Doppler parameters in mural arteries of affected bowel loops for quantitative assessment of Crohn disease (CD) activity in pediatric population and compare Doppler parameters with Pediatric Crohn Disease Activity Index (PCDAI).

Patients and methods: Thirty-four pediatric patients (7 with inactive, 27 with active disease of different severity; 13 male and 21 female; mean age 13; range 7-18) with CD were prospectively evaluated by Doppler ultrasound (DUS) of affected bowel segments. Using semiquantitative color and power Doppler assessment of vascularization of thickened bowel wall and mesentery, patients were divided in four grades. Spectral measurements (peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI)) of mural arteries were compared with PCDAI.

Results: There was a significant difference in distribution of semiquantitative color values between inactive and active group. PSV and EDV values showed no significant difference between inactive and active group, while mean RI was significantly higher in the inactive group. RI was also significantly negatively correlated with PCDAI.

Conclusion: Intensity of color and power Doppler signals and RI measurement of mural arteries in thickened bowel wall is linked to CD activity and therefore might be of use in pediatric patients.

MeSH terms

  • Adolescent
  • Arteritis / complications
  • Arteritis / diagnostic imaging*
  • Child
  • Crohn Disease / complications
  • Crohn Disease / diagnostic imaging*
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / methods*
  • Intestines / blood supply*
  • Intestines / diagnostic imaging*
  • Male
  • Prognosis
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Ultrasonography / methods*
  • Vascular Resistance