Diagnosis and follow-up of Crohn disease (CD) often require invasive instrumental examinations, with a high risk of iatrogenic damage. Ultrasound (US) examination of bowel walls could be the first choice in managing patients with CD. We evaluated the role of tissue color power Doppler (CPD) and B-mode US with intravenous injection of contrast medium in the detection of disease activity. In our series, 52 patients with CD underwent US examination. Each study was completed with tissue CPD and US with intravenous injection of contrast medium (Sono Vue) to evaluate intestinal wall vascularization as an index of disease activity. We then compared our results with those from clinical and laboratory tests and follow-up. Data from US examination with intravenous injection of Sono Vue partly agreed with clinical and laboratory tests and CPD in disease activity evaluation but were most useful in the follow-up. Bowel US examination associated with CPD and in particular US contrast medium injection can be used to detect CD activity and modulate therapy and follow-up.

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Bowel wall thickness >3 mm at ultrasound may be a non-invasive predictor of early surgical recurrence after ileo-colonic resection.

Purpose The aim of this work is to investigate the role of power Doppler sonography as an additional predictor of surgical recurrence in Crohn's disease. Methods A sample of 33 patients, with ileal or ileocolonic Crohn's disease, that had underwent intestinal resection, were retrospectively enrolled. All patients had bowel ultrasonography 7-16 months after resection. Power Doppler sonography of the preanastomotic ileum was evaluated as a possible prognostication tool to assess the risk of long-term need for reoperation. Results The absolute incidence of surgical recurrence in those who had a positive power Doppler was 42 %, while that of those who had a negative power Doppler was 28.6 %. Combining the power Doppler with bowel wall thickness, the surgical recurrence risk grew from 41.2 % of those with a positive power Doppler and thickness [3 mm to 55.6 % of those with a positive power Doppler and thickness [6 mm. Conclusions Power Doppler look to be another useful prediction tool for the personalization of patient's care. It could be useful to perform power Doppler in all patients with a wall thickness [5 mm: for those who have a positive power Doppler it may be indicated as a more aggressive prophylactic therapy.Riassunto Scopo L'obiettivo di questo lavoro è investigare il ruolo del power Doppler ecografico come fattore predittivo aggiuntivo della recidiva chirurgica nella malattia di Crohn. Metodo Un campione di 33 pazienti, con malattia di Crohn ileale o ileo-colica, che sono stati sottoposti a resezione intestinale, sono stati arruolati retrospettivamente. A tutti i pazienti è stata effettuata un'ecografia intestinale nei 7-16 mesi successivi alla resezione. E' stato valutato il power Doppler ecografico dell'ileo pre-anastomotico come un possibile predittore del rischio di necessità di una nuova operazione nel lungo termine. Risultati L'incidenza assoluta di recidiva chirurgica nei pazienti con power Doppler positivo è risultata essere del 42 %, mentre quella nei pazienti con power Doppler negativo è risultata essere del 28.6 %. Unendo i risultati del power Doppler con quelli dello spessore di parete, il rischio di recidiva chirurgica aumenta dal 41.2 % di quelli con power Doppler positivo e spessore di parete intestinale [3 mm al 55.6 % di quelli con power Doppler positivo e spessore di parete [6 mm. Conclusioni Il power Doppler sembra essere un ulteriore utile fattore predittivo per personalizzare la terapia del

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