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Focal bowel wall changes detected with colour Doppler ultrasound: diagnostic value in acute non-diverticular diseases of the colon

¹ Department of Radiology, Université Catholique de Louvain, St-Luc University Hospital, Avenue Hippocrate 10, B-1200 Brussels, ² Center for Biostatistics and Medical Documentation, Mont-Godinne University Hospital, Avenue Therasse 1, B-5530 Yvoir, ³ Department of Internal Medicine, St-Luc University Hospital, Avenue Hippocrate 10, B-1200 Brussels, ⁴ Department of Intensive Care and Emergency Medicine, St-Luc University Hospital, Avenue Hippocrate 10, B-1200 Brussels and ⁵ Department of Surgery, St-Luc University Hospital, Avenue Hippocrate 10, B-1200 Brussels, Belgium

We performed a study to determine if colour Doppler findings may help to identify the cause of wall thickening in acute non-diverticular diseases of the colon. The study group included 66 patients admitted to the emergency department with a final diagnosis of infectious colitis (n=23), inflammatory colitis (n=10), ischaemic colitis (n=23) and malignant tumours (n=10). The following ultrasound features were assessed: maximal wall thickness, wall stratification, arterial flow in the colonic wall and arteriolar resistive index. Higher values of wall thickness were observed in malignant tumour (18.2±6.2 mm, p<0.001). Moderately thickened wall (6.6±1.3 mm, p0.06), preserved stratification (90% versus 46% in the remainder of the study population) and lower resistive index (0.51±0.10, p0.05) were significantly related to inflammatory colitis. Absence of arterial flow was more frequently observed in ischaemia (43% versus 12% in the remainder of the study population). In conclusion, despite some overlap, both ultrasound and colour Doppler features are helpful in the differential diagnosis of colonic thickening related to non-diverticular colonic lesions.