Siğirci A, Baysal T, Kutlu R, Aladağ M, Saraç K, Harputluoğlu H
Department of Radiology, Turgut Ozal Medical Center, Inönü University, 44069 Malatya, Turkey.
J Clin Ultrasound. 2001 Mar-Apr;29(3):130-9. doi: 10.1002/1097-0096(200103/04)29:3<130::aid-jcu1012>3.0.co;2-x.
The purpose of this study was to evaluate the Doppler sonographic blood-flow parameters and spectral patterns in the inferior mesenteric artery (IMA) and superior mesenteric artery (SMA) in patients with active and inactive (remission-phase) ulcerative colitis (UC).
The IMAs and SMAs of 25 patients with active-phase UC (group 1), 19 patients with remission-phase UC (group 2), and 22 healthy, asymptomatic subjects (control group) were evaluated by duplex Doppler sonography. The 25 patients in group 1 were categorized into 2 subgroups on the basis of the extent of disease as determined by double-contrast barium enema x-ray study and colonoscopy. The first subgroup (group 1a) consisted of 11 patients with active involvement of the left colon from the rectum to the splenic flexure. The second subgroup (group 1b) consisted of 14 patients with active involvement of the entire colon. The peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (Vmean), resistance index (RI), and pulsatility index (PI) were determined from the Doppler spectral analysis. The inner diameter and cross-sectional area of the IMA and SMA were measured, and the blood-flow volume was calculated. The results were compared between the patient groups and control subjects.
In the IMA, the mean blood-flow volume, mean PSV, mean EDV, and Vmean were significantly higher, the mean PI was significantly lower, and the mean diameter and the mean cross-sectional area were significantly larger in group 1 than in group 2 or in the control group (p < 0.001). The mean PSV and the Vmean of the IMA were significantly higher in group 1a than in group 1b (p < 0.05). The mean blood-flow parameters in the SMA were not significantly different between groups 1 and 2 or between either group 1 or group 2 and the control subjects. The mean EDV in the SMA was significantly higher and the mean PI and the mean RI were significantly lower in group 1b than in group 1a (p < 0.01).
Duplex Doppler sonography of the IMA and SMA can be used to evaluate inflammatory disease of the large bowel, to assess disease extent, and to document response to therapy.
本研究旨在评估活动期和非活动期（缓解期）溃疡性结肠炎（UC）患者肠系膜下动脉（IMA）和肠系膜上动脉（SMA）的多普勒超声血流参数及频谱形态。
采用双功多普勒超声对25例活动期UC患者（第1组）、19例缓解期UC患者（第2组）和22例健康无症状受试者（对照组）的IMA和SMA进行评估。根据双重对比钡灌肠X线检查和结肠镜检查确定的病变范围，将第1组的25例患者分为2个亚组。第一个亚组（第1a组）由11例直肠至脾曲左半结肠有活动性病变的患者组成。第二个亚组（第1b组）由14例全结肠有活动性病变的患者组成。通过多普勒频谱分析确定收缩期峰值流速（PSV）、舒张末期流速（EDV）、平均流速（Vmean）、阻力指数（RI）和搏动指数（PI）。测量IMA和SMA的内径和横截面积，并计算血流量。将患者组与对照组的结果进行比较。
在IMA中，第1组的平均血流量、平均PSV、平均EDV和Vmean显著更高，平均PI显著更低，平均直径和平均横截面积显著大于第2组或对照组（p < 0.001）。第1a组IMA的平均PSV和Vmean显著高于第1b组（p < 0.05）。第1组和第2组之间，以及第1组或第2组与对照组之间，SMA的平均血流参数无显著差异。第1b组SMA的平均EDV显著高于第1a组，平均PI和平均RI显著低于第1a组（p < 0.01）。
IMA和SMA的双功多普勒超声可用于评估大肠的炎症性疾病、评估疾病范围以及记录对治疗的反应。
