ABSTRACT
BACKGROUND AND STUDY AIMS: The aim of this study was to assess the ability of transabdominal ultrasonographic morphologic features and Doppler flow parameters in differentiating benign from malignant bowel lesions. PATIENTS AND METHODS: Sixty patients with sonographically detected gastrointestinal lesions and 30 control subjects were prospectively enrolled. Bowel wall thickness; length of the affected segment; the wall layering pattern; the resistive index (RI); pulsatility index (PI); flow volume (FV) of the intramural vessels, the superior mesenteric artery (SMA), and the portal vein (PV) were recorded. The final diagnosis was histopathological. Biopsies were obtained endoscopically, ultrasound-guided, or by surgery. RESULTS: Of the patients, 48 proved to be histopathologically malignant and 12 were benign. Malignant bowel lesions were found to have a higher mean wall thickness (a cutoff value of 12.3mm), more frequent loss of wall layering pattern (88.2% vs. 38.9%), a shorter length of affected segment (11.2 vs. 49.2cm); P=0.001. The RI, PI of the intramural vessels and SMA showed no difference between the inflammatory and malignant groups. Ultrasound-guided biopsy was resorted to in 13 patients (21.7%) and it was diagnostic in all of them. CONCLUSION: Ultrasonography is helpful in the characterisation of bowel lesions suggesting their benign or malignant nature. Ultrasound-guided biopsy has certain indications. The Doppler parameters of different pathologies are overlapping and thus are of little help in this regard.
