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Editor,—We read with interest the article by Maconiet al (Gut1998;43:654–650). We find it encouraging that other workers are interested in superior mesenteric artery (SMA) flow concerning Crohn's disease activity. Our group has been working on the subject for several years. However, we found it surprising to read that “according to the literature” SMA flow does not correlate with disease activity. Firstly, disease activity needs to be defined. The Crohn's disease activity index does not correlate with disease activity in individual patients1 2 and the reference standard used by Maconi et al is probably not a reliable indicator for disease activity. Secondly, it is not correct in our view to correlate the resistive index in one article3 with mean velocity in another4 and flow volume in yet another,5 6 and make the statement “yielding conflicting results” on page 654. In our opinion only flow volume measurements can be used as a reliable indicator.5 7 8 The fact that Maconiet al did not find a correlation between SMA volume flow and disease activity is probably caused by their choice of reference standard, as pointed out by Kjeldsen and colleagues,1 Hodgson and Bhatti,2 and van Oostayen and colleagues.5
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