1Department of Abdominal Ultrasound, Kobe City General Hospital, 4-6 Minatojima Nakamachi, Chuo-ku, Kobe 650-0046, Japan, 2Department of Gastroenterology, Kobe City General Hospital, 4-6 Minatojima Nakamachi, Chuo-ku, Kobe 650-0046, Japan, 3Department of Surgery, Kobe City General Hospital, 4-6 Minatojima Nakamachi, Chuo-ku, Kobe 650-0046, Japan, 4Tomita Clinic
Blood flow, Color Doppler sonography, Intestinal diseases
We used color Doppler sonography (CD) to evaluate blood flow and thickening of the wall of the intestine in various bowel diseases in an attempt to evaluate the clinical usefulness of CD for diagnosing various bowel diseases. Two hundred fifty-six patients were studied: 148 had bacterial colitis (BC); 19, ischemic colitis (IC); 10, ulcerative colitis (UC); 13, Crohn's disease (Cd); 4, drug-associated hemorrhagic colitis (DC); 2, Schönlein-Henoch disease; 11, diverticulitis; 32, appendicitis; and 17, advanced colon cancer. Fifty healthy individuals served as controls. The quantity of color flow signals as well as peak flow velocity, pulsatility index, and resistance index were measured in the patients and compared with corresponding values obtained from the healthy controls. BC, UC, and Cd produced readily visible rich flow signals in their early stages. In hemolytic uremic syndrome associated with verotoxin-producing infection by E coli, the echo level in the cortex of the kidney was elevated at first, and blood flow was markedly reduced. In the convalescent stage, blood flow increased and echo level declined. Flow signals were barely visible or absent in the early stages of IC and DC. Diverticulitis of the colon is characterized by arterial flow signals that appear as an arch in the diverticular wall. Quantity of color flow signals in acute appendicitis corresponded closely with grade of inflammatory process. Rich flow signals were detected in 17 patients with advanced colon cancer. Peak velocity, pulsatility index, and resistance index of these pulstile flow signals were 29.9±20.0 cm/s, 2.08±0.80, and 0.84±0.15, respectively. Arterial flow parameters in advanced colon cancer differed significantly from those in the other bowel diseases. These results suggest that CD could play an important role in the hemodynamic diagnosis of various bowel diseases.