Wha-Young Kim MD, Presenter: Research grant, KT&G Corporation, Korea

In-One Kim MD, Abstract Co-Author: Nothing to Disclose

Young Hoon Choi, Abstract Co-Author: Nothing to Disclose

To evaluate the bowel wall and the resistative index (RI) for the superior mesenteric artery (SMA) on sonography after the septic injury in rabbits.

We used 11 New Zealand white rabbits weighed from 600 - 1200 g. We intravenously injected the lipopolysaccharide from E.coli O55-B5 (Sigma-Aldrich Inc.) in 11 rabbits by 1 mg/Kg. We performed bowel sonography (HDI 5000, Philips) with 10 MHz linear probe before and after the injection of toxin for 4-5 hours. We evaluated the bowel wall thickness and echogenicity on the gray scale and measured the RI of the SMA on color Doppler sonography. After sacrifice, we extracted the bowel. We analyzed pathologic findings.

We measured bowel thickness in all rabbits, which was 0.6 - 0.8 mm on the baseline study and increased into 1.6 - 2.0 mm one hour after injection. We found echogenic dots in the bowel walls (less than 10 dots in the axial plane) in all rabbits after 1 to 2 hours and not changed till sacrifice. The RI of the SMA on Doppler sonography was ranged from 0.69-0.83 on the baseline study in all rabbits. Seven rabbits revealed the gradually increased RI (0.9-1.0) of the SMA after 2 to 3 hours and revealed mucosal injury of the bowel walls on pathology (grade I to II of intestinal injury). Four rabbits showed the increased RI (0.9-1.0) of the SMA after one hour and revealed the muscular injury of bowel walls on pathology (grade III). The RI in renal arteries was constant as 0.6-0.7 for 4 hours except one rabbit.

Septic condition could cause damage the mucosa in the bowel wall and lead to the necrotic change. Echogenic dots in the bowel wall on sonography indicated the broken integrity of the bowel wall. Rapid increase in RI of SMA could cause more severe injury of bowel walls.

Sepsis can be a cause of necrotizing enterocolitis in neonate. Sonographic findings of bowel wall and the RI of the SMA on Doppler sonography could help the diagnosis of bowel wall injury in sepsis.

Kim, W, Kim, I, Choi, Y, Bowel Sonography in Sepsis with Pathologic Correlation in Experimental Study.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5014935.html