SONOGRAPHIC ASSESSMENT OF THE NORMAL AND ABNORMAL BOWEL WALL IN NONDIVERTICULAR ILEITIS AND COLITIS

Background: To assess the value of high resolution sonography (HRS) in identifying normal and inflammatory bowel wall in nondiverticular ile itis and colitis by using a segment-by-segment analysis. Methods: Thir ty-five HRS were performed in patients with nondiverticular inflammato ry bowel disease, without knowledge of clinical, endoscopic, and radio logic data. HRS evaluated separately five intestinal segments (termina l ileum, cecum/ascending colon, transverse, descending colon, and sigm oid colon) and was considered positive for inflammation when wall thic kness during compression exceeded 3 mm. We compared HRS findings with results of endoscopy or enteroclysis performed within 8 days of HRS; e ndoscopic and radiologic results were classified into two subgroups: m ild inflammatory lesions and frank inflammatory lesions. Results: Segm ent-by-segment analysis resulted in an accuracy of 81%, a sensitivity of 70%, and a specificity of 93%. Sensitivity was significantly lower for mild lesions (52%) than for frank lesions (87%, p <.001). Of the 3 2 patients having an inflammatory bowel condition, 29 (91%) had at lea st one segment correctly identified as inflammatory by HRS. Conclusion : Even if relatively insensitive for minor lesions, HRS is a promising , minimally invasive method for assessing normal and inflammatory bowe l wall in nondiverticular ileitis and colitis.