Background: Ulcerative colitis (UC) and Crohn's disease (CD) are two varieties of inflammatory
bowel disease (IBD). Clinicians need a monitoring technique in the IBD. The disease
activity can be assessed with endoscopy, activity indexes, and imaging techniques. Color Doppler
US (CDUS) is also a non-invasive, radiation, and contrast material free examination which shows
the intramural blood flow.
Objective: To evaluate the usefulness of B-mode, CDUS, and a newly developed software Color
Quantification (CQ) to determine the activity of the IBD.
Methods: The disease activity was assessed by clinical activity indexes. Caecum, terminal ileum,
ascending colon, transverse colon, and descending colon were evaluated by B-mode, CDUS, and
the CQ. Bowel wall thickness (BWT), loss of bowel stratification, loss of haustration, and the presence
of enlarged lymph nodes, mesenteric masses, abscesses, fistula, visual vascular signal patterns
of the bowel as “hypo and hyper-flow” and the CQ values were investigated. BWT was compared
with laboratory results and clinical activities. Vascular signal patterns and the CQ values were compared
with BWT and clinical activity. The diagnostic performances of the CQ were investigated.
Results: Fifty-two patients with IBD were evaluated. Patients with increased BWT at the transverse
colon had an increased frequency of “hyper-flow” pattern. Clinically active patients had an increased
incidence of “hyper-flow” pattern at the terminal ileum, ascending colon, and whole segments.
They had increased CQ values at the terminal ileum, ascending colon, and descending
colon, and whole segments. A cut-off value for the CQ (24.7%) was obtained at the terminal ileum.
In the diagnostic performances of CQ, we observed utilities significantly at the ascending colon, descending
colon, terminal ileum, and whole segments. There was a positive correlation between the
CQ values and BWT at the caecum, ascending colon, transverse colon, and descending colon.
Conclusion: Increased visual vascular signal scores and CQ values might be useful for monitoring
the disease activity in patients with IBD.