Aktivitätsbestimmung des Morbus Crohn mittels Powerdopplersonographie: ein Vergleich mit der histopathologischen Aktivität

Abstract

Objective: Retrospective comparison of semiquantitatively measured bowel wall vascularity, endoscopic-histopathological biopsy findings and disease activity in patients with confirmed Crohn’s disease. Patients and methods: Thirty-four of a total 1,332 patients with histologically confirmed Crohn’s disease (19 females, 15 males; mean age 37.8 years) met the following inclusion criteria: ileocolonoscopy with biopsy and power Doppler sonographic determination of bowel wall vascularity with assessment of disease activity within a period of five days. The sonographic determination of bowel wall vascularity was based on a semiquantitative score. The endoscopic bowel wall biopsy specimens were assessed using a self-developed inflammation score and the disease activity using the conventional Crohn’s Disease Activity Index (CDAI). Association was determined on the basis of the Kappa-coefficient, McNemar’s Test, logistic regression, sensitivity and specifity. Results: A significant association (p < 0.05) was shown for results of histology and bowel wall vascularity in the terminal ileum (Kappa = 0.66; sensitivity 95%; specificity 69%). There was no observed association between CDAI and histology although there was an association between CDAI and bowel wall vascularity (sensitivity 82%). Discussion: Increased bowel wall vascularity in the terminal ileum as demonstrated by power Doppler ultrasound is associated with histopathologically determined inflammatory activity.