You are here

Article Text

Article menu

Download PDFPDF

Letters to the editor
Use of Doppler ultrasound in Crohn's disease
Free
  1. J A VAN OOSTAYEN,
  2. M N J M WASSER
  1. Leiden University Medical Centre
  2. Department of Diagnostic Radiology, Bldg I, C2-S
  3. Albinusdreef 2, 2333 ZA, Leiden, Netherlands

http://dx.doi.org/10.1136/gut.47.1.156a

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    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

    References

    1. ↵
      1. Kjeldsen J,
      2. Schaffalitzky de Muckadell OB
      (1993) Assessment of disease severity and activity in inflammatory bowel disease. Scand J Gastroenterol 28:1–9.
      OpenUrlPubMedWeb of Science
    2. ↵
      1. Hodgson HJF,
      2. Bhatti M
      (1995) Assessment of disease activity in ulcerative colitis and Crohn's disease. Inflamm Bowel Dis 1:117–134.
      OpenUrl
    3. ↵
      1. Bolondi L,
      2. Gaiani S,
      3. Brignola C,
      4. et al.
      (1992) Changes in splanchnic hemodynamics in inflammatory bowel disease. Non-invasive assessment by Doppler ultrasound flowmetry. Scand J Gastroenterol 27:501–507.
      OpenUrlCrossRefPubMed
    4. ↵
      1. Maconi G,
      2. Imbesi V,
      3. Bianchi Porro G
      (1996) Doppler ultrasound measurement of intestinal blood flow in inflammatoty bowel disease. Scand J Gastroenterol 31:950–953.
      OpenUrl
    5. ↵
      1. Van Oostayen JA,
      2. Wasser MNJM,
      3. Griffioen G,
      4. et al.
      (1997) Doppler sonography evaluation of superior mesenteric artery flow to assess Crohn's disease activity: correlation with clinical evaluation, Crohn's disease activity index, and α1-antitrypsin clearance in feces. AJR Am J Roentgenol 168:429–433.
      OpenUrlCrossRefPubMedWeb of Science
    6. ↵
      1. Hare C,
      2. Hassan MT,
      3. Bartram CI,
      4. et al.
      (1996) Superior mesenteric artery Doppler flow: a valuable indicator of disease activity in Crohn's disease. Gut 38:A639, (abstract).
      OpenUrl
    7. ↵
      1. Van Oostayen JA,
      2. Wasser MNJM,
      3. Van Hogezand RA,
      4. Griffioen G,
      5. De Roos A
      (1994) Activity of Crohn disease assessed by measurement of superior mesenteric artery flow with Doppler US. Radiology 193:551–554.
      OpenUrlCrossRefPubMedWeb of Science
    8. ↵
      1. Van Oostayen JA,
      2. Wasser MNJM,
      3. Griffioen G,
      4. Van Hogezand RA,
      5. C.B.H.W.L,
      6. De Roos A
      (1998) Diagnosis of Crohn's ileitis and monitoring of disease activity: value of Doppler ultrasound of superior mesenteric artery flow. Am J Gastroenterol 93:88–91.
      OpenUrlCrossRefPubMed