DOPPLER SONOGRAPHY OF THE SUPERIOR MESENTERIC-ARTERY IN CROHNS-DISEASE

OBJECTIVE. The aim of this study was to evaluate blood flow in the sup erior mesenteric artery (SMA) in patients with active and inactive Cro hn's disease (CD) using Doppler sonography to dynamically assess the c hanges of resistance in both fasting and postprandial states. SUBJECTS AND METHODS. Doppler sonography of the SMA was performed on 15 patien ts (mean age, 38 +/- 4 years) with active CD and on 15 patients (mean age, 41 +/- 5 years) with inactive CD, Imaging was performed at both f asting and 15 min after an 1890-kJ meal. A preliminary examination of 10 healthy volunteers with no signs of intestinal disease (mean age, 2 8 +/- 2 years) was necessary to define the parameters of normality. Be cause we wanted to express the postprandial resistive change in the SM A, we introduced a parameter called resistive difference (RD), defined as the mathematic difference between the resistive index measured at fasting (highest value) and measured at 15 min after the meal (lowest value). RESULTS. By evaluating the relationship between the RD and ext ension of disease, we found a direct correlation between progressive e xtension of disease and reduction of the RD in patients with active CD (correlation coefficient, .98), whereas we found no such correlation in patients with inactive CD (correlation coefficient, .05). CONCLUSIO N, We believe that Doppler sonography of the SMA is a promising noninv asive method to detect inflammatory disease of the small bowel, to eva luate its extension, and to document resolution of disease after thera py.