BOWEL WALL THICKENING - DIFFERENTIATION OF INFLAMMATION FROM ISCHEMIAWITH COLOR DOPPLER AND DUPLEX US

PURPOSE: To determine whether ultrasonography (US) can be used to diff erentiate inflammatory from ischemic bowel wall thickening. MATERIALS AND METHODS: Thirty-five patients (aged 23-96 years) with inflammatory or ischemic bowel wall thickening underwent US. Thickness was recorde d, echotexture categorized, color Doppler flow graded, presence of int ramural arterial signal recorded, and resistive index calculated. RESU LTS: The difference between inflammatory and ischemic bowel wall thick nesses was not significant (P = .49). Differences in color Doppler flo w (P <.0001), arterial signal (P =.0005), and bowel wall echotexture ( P less than or equal to.0200) between patients with inflammatory and i schemic bowel wall thickening were significant Absence of or barely vi sible color Doppler flow and absence of arterial signal suggested isch emia; readily visible color Doppler flow and a stratified echotexture suggested inflammation. A resistive index less than 0.60 indicated inf lammation. The difference in resistive index between the two groups wa s not significant (P =.12). CONCLUSION: Duplex and color Doppler flow US are helpful in differentiation between ischemic and inflammatory bo wel wall thickening.