Crohn disease: diagnosis by graded compression ultrasound

Fifty-four patients with suspected Crohn's disease of the small bowel underwent ultrasound examination with graded compression. The pathologic sonographic findings were compared with the clinical, endoscopic and in 32 cases with the parallel performed CT and selective enterographic examinations. Of the 29 proven cases of Crohn's disease 26 (89.7%) had bowel wall thickening detectable with US. The change in the bowel wall structure correlated to the stage of the disease. The luminal narrowing, the mesenteric involvement, the enlargement of the mesenteric lymph nodes, the abscesses and fistulas were judged easily, but the length and the location of the bowel segment were estimated only approximately. The characteristic but nonspecific signs observed by ultrasound were found to be a useful adjunct to the endoscopic and roentgen examinations. The ultrasound with graded compression in our view is a well usable alternative method for both diagnosis and follow-up, informing about the transmural spread of the pathology.