COLOR DOPPLER SONOGRAPHY OF FOCAL GASTROINTESTINAL LESIONS - INITIAL CLINICAL-EXPERIENCE

Graded compression color Doppler sonography was used to evaluate gastr ointestinal blood flow in 20 normal fasting subjects, and 32 patients with focal gastrointestinal lesions. Imaging was optimized for color s ensitivity using a 5 MHz linear array transducer. Criteria were establ ished for normal mural blood flow based on findings in normal controls . Two reviewers blinded to the final diagnosis compared patterns of mu ral vascularity in normal and abnormal patients. Increased mural blood flow was demonstrated in all 32 patients with gastrointestinal inflam matory disorders and in seven of nine patients with neoplasms. No mura l flow was demonstrated in four patients with small bowel infarction. The greatest overall degree of flow was noted in patients with Crohn's disease an cytomegalovirus colitis. Flow in tumors was variable, rang ing from stirkingly increased flow in a giant villoglandular polyp to absent flow in a metastasis from lung carcinoma. Our preliminary exper ience suggests that the presence of considerable overlap in the color Doppler patterns of mural blood flow in inflammatory and neoplastic le sions. Color Doppler sonography alone without spectral waveform analys is may not distinguish focal inflammatory from neoplastic disorders of the gastrointestinal tract reliably. However, this technique potentia lly may be useful in diagnosing small bowel ischemia when thickened se gments of small bowel are identified With absent flow.