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Bowel wall thickening: differentiation of inflammation from ischemia with color Doppler and duplex US
S A Teefey1, M C Roarke, J A Brink
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA.
Purpose:
To determine whether ultrasonography (US) can be used to differentiate inflammatory from ischemic bowel wall thickening.
Materials And Methods:
Thirty-five patients (aged 23-96 years) with inflammatory or ischemic bowel wall thickening underwent US. Thickness was recorded, echotexture categorized, color Doppler flow graded, presence of intramural arterial signal recorded, and resistive index calculated.
Results:
The difference between inflammatory and ischemic bowel wall thicknesses was not significant (P = .49). Differences in color Doppler flow (P < .0001), arterial signal (P = .0005), and bowel wall echotexture (P < or = .0200) between patients with inflammatory and ischemic bowel wall thickening were significant. Absence of or barely visible color Doppler flow and absence of arterial signal suggested ischemia; readily visible color Doppler flow and a stratified echotexture suggested inflammation. A resistive index less than 0.60 indicated inflammation. The difference in resistive index between the two groups was not significant (P = .12).
Conclusion:
Duplex and color Doppler flow US are helpful in differentiation between ischemic and inflammatory bowel wall thickening.