DOPPLER SONOGRAPHY EVALUATION OF SUPERIOR MESENTERIC-ARTERY FLOW TO ASSESS CROHNS-DISEASE ACTIVITY - CORRELATION WITH CLINICAL-EVALUATION, CROHNS-DISEASE ACTIVITY INDEX, AND ALPHA(1)-ANTITRYPSIN CLEARANCE IN FECES

OBJECTIVE. This study was undertaken to investigate the value of Doppl er flow measurements of the superior mesenteric artery (SMA) as a mark er for disease activity in patients with Crohn's disease. SUBJECTS AND METHODS. Duplex Doppler sonography measurements of SMA blood flow vol ume were obtained in 29 consecutive patients with suspected Crohn's di sease. We prospectively sought a correlation between the independent a ssessment of Doppler flow measurements and markers for disease activit y: Crohn's disease activity index and fecal alpha(1)-antitrypsin clear ance and our reference standard based on clinical history, physical ex amination, laboratory values, endoscopy, surgery, and follow-up. RESUL TS. In 27 of 29 patients, adequate measurements of SMA blood flow were obtained. In 15 patients no disease activity was judged to be present or no Crohn's disease (n = 2) was found at follow-up (group 1). In 12 patients, activity of Crohn's disease was diagnosed (group 2) on the basis of the reference standard. In group 2 the Doppler SMA blood flow values were significantly higher (p < .05) than those for group 1 (82 6 +/- 407 ml/min ver sus 323 +/- 103 ml/min). Of the other parameters investigated, only the alpha(1)-antitrypsin value correlated with the reference standard but to a lesser degree than the values for SMA bloo d flow measurement. CONCLUSION. This prospective study shows that SMA Doppler blood flow measurements can be used to assess disease activity in patients with Crohn's disease. This approach may be of value in th e diagnosis and follow-up of patients with Crohn's disease, providing directly available, quantifiable, noninvasive information on disease a ctivity.