Thickened Submucosal Layer
A Sonographic Sign of Acute Gastrointestinal Abnormality Representing Submucosal Edema or Hemorrhage
Joan K. Frisoli1,
Terry S. Desser1,2 and
R. Brooke Jeffrey1
1
Department of Radiology, Stanford University Medical Center, 300 Pasteur Dr.,
Rm. H1307, Stanford, CA 94305.
2
Department of Radiology, Mail stop 114, Veterans Administration Palo Alto
Health Care System, 3801 Miranda Ave., Palo Alto, CA 94304.
View larger version (140K):
[in a new window]
|
Fig. 1A. —33-year-old woman with lupus vasculitis of large and small
bowel. Transverse sonogram of ileum shows thickened echogenic submucosal layer
(arrow).
|
|
View larger version (98K):
[in a new window]
|
Fig. 1B. —33-year-old woman with lupus vasculitis of large and small
bowel. Contrast-enhanced CT scan shows "double ring" sign of
submucosal edema of affected bowel loop (arrow).
|
|
View larger version (103K):
[in a new window]
|
Fig. 2A. —21-year-old man with pseudomembranous colitis. Sagittal
sonogram of ascending colon shows thickened echogenic submucosal layer
(arrow).
|
|
View larger version (106K):
[in a new window]
|
Fig. 2B. —21-year-old man with pseudomembranous colitis.
Contrast-enhanced CT scan shows low-attenuation bowel wall consistent with
submucosal edema (arrow).
|
|
View larger version (112K):
[in a new window]
|
Fig. 3A. —36-year-old woman with thrombocytopenia and intramural
hemorrhage of ileum. Sagittal sonogram of ileum shows thickened echogenic
submucosal layer (arrow).
|
|
View larger version (99K):
[in a new window]
|
Fig. 3B. —36-year-old woman with thrombocytopenia and intramural
hemorrhage of ileum. Unenhanced CT shows high attenuation (54 H) within
thickened bowel wall (arrow). Small amount of adjacent hemoperitoneum
is noted.
|
|
View larger version (113K):
[in a new window]
|
Fig. 4A. —41-year-old man with pancolitis from ulcerative colitis with
acute exacerbation of left-sided colitis. Sagittal sonogram of descending
colon showing thickened echogenic submucosal layer.
|
|
View larger version (117K):
[in a new window]
|
Fig. 4B. —41-year-old man with pancolitis from ulcerative colitis with
acute exacerbation of left-sided colitis. Transverse sonogram of ascending
colon shows predominantly hypoechoic mural thickening with faint visualization
of submucosal layer.
|
|
View larger version (90K):
[in a new window]
|
Fig. 4C. —41-year-old man with pancolitis from ulcerative colitis with
acute exacerbation of left-sided colitis. Contrast-enhanced CT scan reveals
submucosal edema of descending colon (short arrow). Note nonspecific
thickening of ascending colon (long arrow) from chronic disease.
|
|
View larger version (128K):
[in a new window]
|
Fig. 4D. —41-year-old man with pancolitis from ulcerative colitis with
acute exacerbation of left-sided colitis. Contrast-enhanced CT scan also shows
prominent submucosal edema of sigmoid colon (arrow).
|
|
View larger version (148K):
[in a new window]
|
Fig. 5A. —74-year-old man with acute hemorrhagic infarction of distal
ileum. Transverse color Doppler sonogram of ileum shows absent flow within
thickened hypoechoic bowel and lack of visualization of echogenic submucosal
layer.
|
|
View larger version (117K):
[in a new window]
|
Fig. 5B. —74-year-old man with acute hemorrhagic infarction of distal
ileum. Unenhanced CT scan reveals high attenuation (56 H) within thickened
ileum (cursor).
|
|
View larger version (104K):
[in a new window]
|
Fig. 6A. —45-year-old woman with chronic left lower quadrant pain and
chronic ischemic colitis. Transverse sonogram of sigmoid colon shows
hypoechoic thickening of sigmoid with loss of visualization of submucosal
layer.
|
|
View larger version (109K):
[in a new window]
|
Fig. 6B. —45-year-old woman with chronic left lower quadrant pain and
chronic ischemic colitis. Endoscopic image reveals changes consistent with
subacute ischemic colitis confirmed at biopsy.
|
|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Copyright © 2000 by the American Roentgen Ray Society.
