ASSESSMENT OF THE ROLE AND RELIABILITY OF SONOGRAPHIC POSTPRANDIAL FLOW RESPONSE IN GRADING CROHNS-DISEASE ACTIVITY

Purpose: To investigate the value of pre and post prandial Duplex colo ur Doppler sonographic (DCDS) measurement of superior mesenteric arter y (SMA) flow in the assessment of Crohn's disease activity, and its re sponse to treatment. Materials and Methods: SMA volume flow rates befo re and after a food challenge (200 ml of Ensure Plus) were recorded ov er 60 min in 11 controls, and 25 patients with proven Crohn's disease. Peak flow rates and the time interval to peak flow were recorded. Ele ven patients with active disease were monitored longitudinally and the ir response following the introduction of systemic steroids was assess ed. Results: The time interval from food challenge to peak SMA flow ra te was significantly lower in patients,vith untreated active disease ( median 20 min, range 14.5-21.25) compared to inactive patients (median 33 mins, range 28.75-40.5, P = 0.0006), Longitudinal follow-up of act ive disease demonstrated prolongation of time to peak flow following c linical remission (P = 0.0024) Conclusions: This technique is useful i n offering an immediate, noninvasive means of assessing disease activi ty. Further longitudinal follow up data is necessary to determine its utility in assessing response to treatment.