Doppler US in patients with Crohn disease: Vessel density in the diseased bowel reflects disease activity

PURPOSE: To determine if neovascularization associated with Crohn disease, as detected with Doppler ultrasonography (US), reflects clinical disease ac tivity. MATERIALS AND METHODS: A devised measurement, vessel density, was estimated with color Doppler US. Patients with Crohn disease underwent clinical and laboratory assessment in which the Crohn disease activity index was measure d; patients underwent abdominal US the same week. Color Doppler US was perf ormed by using a 7.5-10.0- or 8.0-12.0-MHz transducer, the lowest possible pulse repetition frequency without aliasing, a low wall filter, and high Do ppler gain settings. The length and thickness of the affected loops were me asured, and the number of color Doppler signals per square centimeter in th e bowel loop was counted. Pulsed Doppler US was used to confirm that the si gnals originated from arteries or veins and not from movement artifacts. RESULTS: Ninety-two patients (aged 7-20 years; mean, 14.85 years; 44 female , 48 male) underwent 119 examinations; 85 were performed in patients with a ctive disease. Affected loops were thicker (10.6 vs 4.6 mm; P < .001) and h ad a higher vessel density with disease (69 of 119 examinations) than durin g remission (two of 34 examinations; P < .001). CONCLUSION: Vessel density in affected bowel loops, as estimated with Doppl er US, and bowel wall thickness (>5 mm) reflect disease activity in patient s with Crohn disease.