Sonography of the small intestine

Figure 3 In vitro examination of a stenotic terminal ileum in a patient with CD. The intestine has been cut open longitudinally and is resting on agar. The image was acquired with a 13-MHz linear probe (Hitachi Medical Systems Europe Holding AG, Zug, Switzerland) applied directly to the mucosa. The left image is an ordinary B-mode image showing the thickened GI wall (> 1 cm in vitro) with the muscularis propria (MP), submucosa (SM), mucosa (M) and a thickened muscularis mucosa (MM). Towards the stenosis (S), the stratification is lost. In the right corresponding elastography image, there is a clear transition between the blue (hard) stenotic area and the red (soft) pre-stenotic area. The strain measured in region A and B (yellow circles) differ with a ratio of 3.77 ( A: 0.27%; B: 1.02%; B/A: 3.77), which indicates a distinct difference in elasticity. Histology confirmed a fibrotic stenosis (Bar indicates 0.5 cm/unit).