Evaluation of Doppler-Derived Vascularity Indices as Non-Invasive Biomarkers for Monitoring Therapeutic Response and Mucosal Healing in Severe Inflammatory Bowel Disease

Original Article

Abstract

Objectives: To evaluate Doppler-derived vascularity indices and bowel-wall measurements as markers of therapeutic response and mucosal healing in severe IBD.

Methodology: A prospective observational study included 96 patients aged 18–60 years at Jinnah Hospital, Lahore, recruited through non-probability purposive sampling following written informed consent. Intestinal ultrasound assessed bowel-wall thickness (BWT), peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), pulsatility index (PI), and vascularity grade at baseline and follow-up. We analyzed clinical, laboratory, and available endoscopic findings using SPSS version 25, with p ≤ 0.05 considered significant.

Results: BWT decreased significantly from 5.63 ± 1.29 to 3.96 ± 1.15 mm (p < 0.001). PSV and EDV decreased, while RI and PI increased, indicating reduced bowel-wall hyperemia. ESR and fecal calprotectin decreased significantly. Follow-up BWT strongly correlated with fecal calprotectin (r = 0.83, p < 0.001). Mean BWT reductions were approximately 0.60, 1.48, and 2.56 mm among non-responders, partial responders, and complete responders, respectively.

Conclusion: BWT and Doppler parameters demonstrated promising associations with therapeutic response. Multiparametric intestinal ultrasound may complement clinical, laboratory, and endoscopic assessment for non-invasive monitoring; however, its ability to establish mucosal healing requires further validation against endoscopy