Limberg score is a semiquantitative color Doppler ultrasound assessment of the bowel wall vascularity in inflammatory bowel disease.
- grade 0: normal bowel wall with no thickening (<4 mm), well-delineated mural stratification, no mural flow (no color Doppler signal)
- grade 1: wall thickening (hypoechoic wall thickening and partially obscured mural stratification) and absent mural flow
- grade 2 ("hypo-flow"): wall thickening with intermittent (or "spot") increases in vascularity
- grade 3 ("hyper-flow"): wall thickening with protracted stretches of increased vascularity
- grade 4 ("hyper-flow"): color flow Doppler signals in both the bowel wall and surrounding mesenteric fat
Practical points
- increased vascularization (Limberg score 2 or above) is considered abnormal
- hyperemia or increased vascularization is defined based on color Doppler signal with the patient’s breath held in expiration
- vascularity should be assessed with a high frequency linear array probe
- the original study used retrograde water instillation (hydrocolonic sonography), however more recent investigators successfully applied the scoring system to ultrasonography without such preparations 2
- it has been shown that the Limberg score demonstrates good correlation with endoscopic and gross surgical disease severity 2
Unable to process the form. Check for errors and try again.