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Resistance index in mural arteries of thickened bowel wall: predictive value for Crohn disease activity assessment in pediatric patients

Resistance Index in intramuralen Arterien der verdickten Darmwand: Vorhersagewert bei der Beurteilung der Krankheitsaktivität des Morbus Crohn in pädiatrischen Patienten

Summary

Objective

To define reliable Doppler parameters in mural arteries of affected bowel loops for quantitative assessment of Crohn disease (CD) activity in pediatric population and compare Doppler parameters with Pediatric Crohn Disease Activity Index (PCDAI).

Patients and methods

Thirty-four pediatric patients (7 with inactive, 27 with active disease of different severity; 13 male and 21 female; mean age 13; range 7–18) with CD were prospectively evaluated by Doppler ultrasound (DUS) of affected bowel segments. Using semiquantitative color and power Doppler assessment of vascularization of thickened bowel wall and mesentery, patients were divided in four grades. Spectral measurements (peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI)) of mural arteries were compared with PCDAI.

Results

There was a significant difference in distribution of semiquantitative color values between inactive and active group. PSV and EDV values showed no significant difference between inactive and active group, while mean RI was significantly higher in the inactive group. RI was also significantly negatively correlated with PCDAI.

Conclusion

Intensity of color and power Doppler signals and RI measurement of mural arteries in thickened bowel wall is linked to CD activity and therefore might be of use in pediatric patients.

Zusammenfassung

Ziel

Das Ziel dieser Studie war es, die zuverlässigen Doppler-Parameter in den intramularen Arterien der betroffenen Darmschlingen zur quantitativen Bewertung der Aktivität des Morbus Crohn (CD) bei der pädiatrischen Population zu definieren und die Doppler-Parameter mit dem pädiatrischem Morbus Crohn Aktivitätsindex (PCDAI) zu vergleichen.

Patienten und Methoden

Der Zustand von 34 pädiatrischen Patienten (7 mit inaktiver, 27 mit aktiver Erkrankung unterschiedlichen Schweregrades, 13 männliche und 21 weibliche, Alter 7–18, Durschnittsalter 13) mit M. Crohn wurde prospektiv anhand des Doppler-Ultraschall (DUS) betroffener Darmsegmente ausgewertet. Anhand der semi-quantitativen Farb- und Power-Doppler-Beurteilung der Vaskularisation der verdickten Darmwand und des Mesenteriums wurden die Patienten in 4 Gruppen unterteilt. Die spektrale Messungen (die maximale systolische Strömungsgeschwindigkeit – PSV, die enddiastolische Strömungsgeschwindigkeit – EDV, der Resistance-Index – RI) intramuraler Arterien wurden mit PCDAI verglichen.

Ergebnisse

Es bestand ein signifikanter Unterschied in der Verteilung der semi-quantitativen Farbwerte zwischen der inaktiven und aktiven Gruppe. PSV und EDV-Werte zeigten keinen signifikanten Unterschied zwischen der inaktiven und der aktiven Gruppe, während der mittlere RI in der inaktiven Gruppe signifikant höher war. Der RI war ebenfalls signifikant negativ mit dem PCDAI korreliert.

Schlussfolgerung

Die Intensität der Farb- und Power-Doppler-Signale und die RI-Messung in den intramuralen Arterien der verdickten Darmwand stehen im Zusammenhang mit der Aktivität des Morbus Crohn und können daher bei pädiatrischen Patienten von Nutzen sein.

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The authors declare that they have no conflicts of interest or financial interests with any organization involved in the research.

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Correspondence to V. Šunjara.

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Sjekavica, I., Barbarić-Babić, V., Šunjara, V. et al. Resistance index in mural arteries of thickened bowel wall: predictive value for Crohn disease activity assessment in pediatric patients. Wien Klin Wochenschr 125, 254–260 (2013). https://doi.org/10.1007/s00508-013-0357-8

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  • DOI: https://doi.org/10.1007/s00508-013-0357-8

Keywords

  • Pediatric Crohn disease
  • Doppler ultrasound
  • Disease activity
  • Bowel wall
  • Resistance index

Schlüsselwörter

  • Pädiatrischer Morbus Crohn
  • Doppler-Ultraschall
  • Krankheitsaktivität
  • Darmwand
  • Resistance Index