Abstract:
Purpose. The purpose of this study was to
evaluate the Doppler sonographic blood-flow parameters
and spectral patterns in the inferior mesenteric
artery (IMA) and superior mesenteric artery (SMA) in
patients with active and inactive (remission-phase) ulcerative
colitis (UC).
Methods. The IMAs and SMAs of 25 patients with
active-phase UC (group 1), 19 patients with remissionphase
UC (group 2), and 22 healthy, asymptomatic
subjects (control group) were evaluated by duplex
Doppler sonography. The 25 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 study and colonoscopy. The first
subgroup (group 1a) consisted of 11 patients with active
involvement of the left colon from the rectum to
the splenic flexure. The second subgroup (group 1b)
consisted of 14 patients with active involvement of
the entire colon. The peak systolic velocity (PSV), enddiastolic
velocity (EDV), mean velocity (Vmean), resistance
index (RI), and pulsatility index (PI) were determined
from the Doppler spectral analysis. The inner
diameter and cross-sectional area of the IMA and
SMA were measured, and 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 Vmean 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 PSV and the
Vmean of the IMA were significantly higher in group
1a than in group 1b (p < 0.05). The mean blood-flow
parameters in the SMA were not significantly different
between groups 1 and 2 or between either group 1 or
group 2 and the control subjects. The mean EDV in the
SMA was significantly higher and the mean PI and the
mean RI were significantly lower in group 1b than in
group 1a (p < 0.01).
Conclusions. Duplex Doppler sonography of the
IMA and SMA can be used to evaluate inflammatory
disease of the large bowel, to assess disease extent,
and to document response to therapy.
