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1
Department of Diagnostic Imaging and Radiology, Children's National Medical
Center, 111 Michigan Ave., N.W., Washington, DC 20010.
2
Department of Pediatrics, Children's National Medical Center, Washington, DC
20010.
3
Present address: Department of Radiology, MCHK-DR, Tripler Army Medical
Center, 1 Jarrett White Rd., Honolulu, HI 96859-5000.
4
Department of Gastroenterology, Children's National Medical Center,
Washington, DC 20010.
5
Present address: Division of Pediatric Gastroenterology and Nutrition,
Pasquerilla Healthcare Center, 2nd Fl., 3800 Reservoir Rd., N.W., Washington,
DC 20007.
OBJECTIVE. The objective of this study was to evaluate the sonographic findings of inflammatory bowel disease activity in children undergoing treatment.
SUBJECTS AND METHODS. Eighty-eight sonograms were obtained of 23 bowel segments in 17 children and young adults (age range, 10-21 years; mean, 16 years) with new or recurrent inflammatory bowel disease. Sixteen segments were involved with Crohn's disease and seven with ulcerative colitis. Serial sonography (range, two to eight examinations; mean, four per segment) was performed while patients underwent treatment. Bowel wall thickness measurements and color and power Doppler sonography grading were recorded and compared with clinical data.
RESULTS. All 17 patients had at least one abnormal bowel segment on initial sonography. The correlation was significant (p < 0.01). Agreement was 91% on direction of change over time between bowel wall thickness and Doppler grades, with 100% correlation between color and power Doppler sonography grades. In patients with Crohn's disease, the correlation was significant (p < 0.05) between bowel wall thickness and Doppler grades with two of seven and four of seven clinical parameters, respectively. In patients with ulcerative colitis, the correlation was significant (p < 0.05) between bowel wall thickness and Doppler sonography grades with four of seven and three of seven clinical parameters, respectively. The erythrocyte sedimentation rate correlated with all sonographic measurements in both patient groups. Combining bowel wall thickness and Doppler sonography, the percentage of agreement was significant in the direction of change, with five of seven clinical parameters in both patient groups.
CONCLUSION. Gray-scale and color or power Doppler sonography can show changes in disease activity in children and young adults undergoing treatment for inflammatory bowel disease.
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