Clinical evaluation of severity and depth of inflammation in Crohn's disease using ultrasonic miniture probe

Endoscopic ultrasonography (EUS) has been evaluated for diagnosing and staging of a variety of gastrointestinal tumors, but there are no data on EUS in Crohn's disease. The aim of present study was to evaluate the depth of inflammation in vertical direction of intestinal wall with Crohn's disease. From June 1995 to June 1997, 33 cases of Crohn's disease (7 cases of cobblestone appearance, 5 irregular shaped ulcers, 4 longitudinal ulcers, 5 discrete ulcers, 6 aphthoid ulcers, 6 pseudopolyposis and 2 stenosis) and 30 healthy controls were examined by EUS. Through the channel, the severity and depth of inflammation were evaluated using ultrasonic miniture probe (UM-2R, 12MHz, Olympus Co) with water filling method. Results ; 1) Submucosal (SM) layers in the protrusion of cobblestone and pseudopolyposis were significantly thicker than those of healthy controls. SM layer was significantly thicker in cobblestone than that of pseudopolyposis (p<0.01). 2) Thickness of muscularis propria (MP) layer was significantly higher in cobblestone and pseudopolyposis compared with healthy controls (p<0.01). There was no significant differrence in the MP layer between cobblestone and pseudopolyposis. 3) Thickness of SM and MP layers had no significant difference in aphthoid and discrete ulcer compared with healthy controls. 4) MP layer was significantly thicker than SM layer in stenosis. In addition to horizontal direction with the aid of endoscopy, we inspected the depth of inflammation in vertical direction by ultrasonography in EUS. We conclude EUS can make us understand the clinical severity of Crohn's disease more precisely.