Doppler Sonography in Inflammatory Bowel Disease

Zusammenfassung

Der Verlauf chronisch entzündlicher Darmerkrankungen ist sehr variabel und die Vorhersage eines Rezidivs entsprechend schwierig. Die Doppler-Sonographie ist ein neueres nicht invasives Verfahren, um die charakteristische Entzündungshyperämie in den Mesenterialarterien zu messen. Obwohl dieses Verfahren zur Aktivitätsbeurteilung bislang nur in einigen spezialisierten Zentren eingesetzt wird, können durch Einführung der hochauflösenden Power-Doppler-Sonographie, evtl. mit zusätzlicher Gabe von Kontrastmitteln, mukosale und transmurale entzündliche Darmwandveränderungen sehr frühzeitig festgestellt werden. Bedeutsamer ist die Erkenntnis, dass durch wiederholte Messungen des mesenterialen Blutflusses das Ansprechen auf eine Steroidtherapie über 6 Monate voraussagbar ist. Zukünftige Untersuchungen sollten klären, ob durch den kombinierten Einsatz der mesenterialen und Darmwand-Doppler-Sonographie Therapieentscheidungen besser steuerbar werden.

Abstract

The course of chronic inflammatory bowel diseases is highly variable and prediction of relapse remains difficult. Doppler sonography is a newer, non-invasive method to assess the hyperdynamic splanchnic blood flow that is characteristic of acute inflammation. Its role in the analysis of disease activity is still limited and its application restricted to specialized units. However, improved spatial resolution by power Doppler ultrasound, with or without the use of contrast agents, allows a very early detection of mucosal and transmural inflammatory lesions. Still more important, the repeated quantification of mesenteric blood flow enables the prediction of relapse at six months after steroid-induced remission. Future studies should clarify whether the combined application of available methods will allow a more calculated and finally more effective therapy.

Schlüsselwörter

Doppler-Sonographie - chronisch entzündliche Darmerkrankungen - Diagnostik - Morbus Crohn - Colitis ulcerosa

Key words

Doppler Sonography - inflammatory bowel disease - diagnosis - Crohn’s disease - ulcerative Colitis

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