EVALUATION WITH DOPPLER SONOGRAPHY OF MESENTERIC BLOOD-FLOW IN CELIAC-DISEASE

OBJECTIVE. The aim of this study was to investigate with Doppler sonog raphy the variations of resistance in the superior mesenteric artery, both at fasting and in the postprandial state, in patients with celiac disease. SUBJECTS AND METHODS, Twenty-five patients with celiac disea se (20 women, five men; mean age, 30 +/- 7 years) and 10 healthy volun teers (seven women, three men; mean age, 28 +/- 6 years) were examined with Doppler sonography. Nineteen patients were untreated (no dietary restrictions) and six patients were treated with a gluten-free diet a t the One of the examination. Imaging was performed at both fasting an d 15 min after an 1890-kJ meal. We introduced a parameter called ''res istive difference,'' defined as the mathematic difference between the resistive index measured at fasting (highest value) and that measured at 15 min after the meal (lowest value) as a way to express the postpr andial resistive change in the superior mesenteric artery. RESULTS. Un treated patients with flat mucosa showed a resistive difference of 0.0 3 +/- 0.05, followed by untreated patients with mucosal subatrophy (0. 05 +/- 0.04), treated patients (0.09 +/- 0.02), and healthy volunteers (0.12 +/- 0.04). A statistically significant difference was noticed b etween the resistive difference of healthy volunteers and both those o f the untreated patients with subatrophy (p =.016) and of the patients with complete atrophy (p =.011), as well as between the resistive dif ference of the treated patients and both those of the untreated patien ts with subatrophy (p =.021) and of the patients with complete atrophy (p =.020). CONCLUSION. We believe that Doppler measurement of resisti ve difference in the superior mesenteric artery can be an effective wa y to express severity of celiac disease and to document its regression after diet therapy.