Crohn's disease and color Doppler sonography: Response to treatment and its relationship with long‐term prognosis

Abstract

Sonography can identify bowel inflammation and its changes during treatment. In patients with Crohn's disease, hyperemia on color Doppler sonography during clinical remission after treatment may reflect an increased risk of relapse.

Abdominal Sonographic Changes After Antibody to Tumor Necrosis Factor (Anti-TNF) Alpha Therapy in Crohn’s Disease

“…Previously published studies monitoring the response to medical [19,20] or surgical [21] treatment using sonography have observed that despite obtaining a positive clinical response, the thickness and the colour Doppler of the bowel wall may remain increased reflected an increased risk of relapse. In the present study, normal sonographic findings were observed in only 29% of patients in whom the therapy was effective, compared to none of the patients who were refractory to anti-TNF treatment.…”

“…Measuring the bowel wall thickness or quantifying its vessels using colour Doppler is technically a much more simple and fast method. Likewise, bowel wall thickness and colour Doppler in the wall have been used to evaluate the response to classical medical treatments [19,20] and even following traditional surgery [21] too. However, the role of sonography in the analysis the response to new biological therapies has only been assessed in the case of perianal CD [6][7][8].…”

Ultrasound features of pediatric Crohn disease: a guide for case interpretation

“…Each bowel segment is scanned in the transverse and longitudinal planes and evaluated with color Doppler to assess hyperemia. Color Doppler should be performed at a low pulse repetition frequency with a low wall filter, low velocity scale and highest Doppler gain [6,17,18]. Extra-intestinal structures such as the mesentery are also evaluated with gray-scale and color Doppler simultaneously with each bowel segment [6].…”

“…By estimating the vessel density in the intestinal wall using Doppler color signals per square centimeter, Spalinger et al [19] demonstrated a sensitivity of 81% and specificity of 69% for active Crohn disease with high vessel density (greater than 5 signals per square centimeter) and a sensitivity of 98% and specificity of 89% for active Crohn disease with moderate to high vessel density (3 to 5 signals per square centimeter). Additionally, residual hyperemia following treatment had an unfavorable clinical course [18].…”

Is This Stricture Inflammatory?

“…Ultrasound has been shown to be useful for the clinical management of CD [8][9][10][11][12] . Ultrasound results have been shown to be predictive for the disease behavior [10][11][12][13][14][15][16] , which is of importance in the context of the study presented in this issue of Digestion .…”