Doppler sonography of the inferior and superior mesenteric arteries in ulcerative colitis

Purpose. The purpose of this study was to evaluate the Doppler sonographic blood-flow parameters and spectral patterns in the inferior mesenteric arte ry (IMA) and superior mesenteric artery (SMA) in patients with active and i nactive (remission-phase) ulcerative colitis (UC). Methods. The IMAs and SMAs of 25 patients with active-phase UC (group 1), 1 9 patients with remission-phase UC (group 2), and 22 healthy, asymptomatic subjects (control group) were evaluated by duplex Doppler sonography. The 2 5 patients in group 1 were categorized into 2 subgroups on the basis of the extent of disease as determined by double-contrast barium enema x-ray stud y and colonoscopy. The first subgroup (group 1a) consisted of 11 patients w ith active involvement of the left colon from the rectum to the splenic fle xure. The second subgroup (group 1b) consisted of 14 patients with active i nvolvement of the entire colon. The peak systolic velocity (PSV), end diast olic velocity (EDV), mean velocity (Vmean), resistance index (RI), and puls atility index (PI) were determined from the Doppler spectral analysis. The inner diameter and cross-sectional area of the IMA and SMA were measured, a nd the blood-flow volume was calculated. The results were compared between the patient groups and control subjects. Results. In the IMA, the mean blood-flow volume, mean PSV, mean EDV, and Vm ean were significantly higher, the mean PI was significantly lower, and the mean diameter and the mean cross-sectional area were significantly larger in group 1 than in group 2 or in the control group (p < 0.001). The mean PS V and the Vmean of the IMA were significantly higher in group la than in gr oup Ib (p < 0.05). The mean blood-flow parameters in the SMA were not signi ficantly different between groups 1 and 2 or between either group 1 or grou p 2 and the control subjects. The mean EDV in the SMA was significantly hig her and the mean PI and the mean RI were significantly lower in group 1b th an in group 1a (p < 0.01). Conclusions. Duplex Doppler sonography of the IMA and SMA can be used to ev aluate inflammatory disease of the large bowel, to assess disease extent, a nd to document response to therapy. (C) 2001 John Wiley & Sons, Inc.