Intestinal Ultrasonography as a Tool for Monitoring Disease Activity in Patients with Ulcerative Colitis

Abstract

Background. Ultrasonography is a noninvasive, inexpensive, and widely available diagnostic tool. In the last two decades, the development of ultrasound techniques and equipment has significantly increased the usage of intestine ultrasound (US) in the assessment of the gastrointestinal tract in patients with inflammatory bowel disease (IBD). Although current guidelines suggest routine utilization of US in patients with Crohn’s disease, data regarding US usage in ulcerative colitis are still scarce. We aimed to assess the reliability of intestinal ultrasonography in the assessment of disease activity and extension of patients with ulcerative colitis. Methods. Fifty-five patients with a histologically confirmed diagnosis of ulcerative colitis, treated at University Clinical Center of Serbia in the period from 2019 to 2022 were included in this retrospective observational study. The data were obtained from the patient’s medical records including history, laboratory, US, and endoscopy findings. US examined parameters were as following: bowel wall thickness (BWT), presence of fat wrapping, wall layer stratification, mesenteric hypertrophy, presence of enlarged mesenteric lymph nodes, and absence or presence of ascites. Results. Our results suggest that there is a strong correlation of BWT and colonoscopy findings regarding disease extension (r = 0.524, p = 0.01 , p < 0.05 ). Furthermore, our results have shown a statistically significant correlation of BWT with the Mayo endoscopic score (r = 0.434, p = 0.01 , p < 0.05 ), disease activity score (r = 0.369, p = 0.01 , p < 0.05 ), degree of ulcerative colitis burden of luminal inflammation (r = 0.366, p = 0.01 , p < 0.05 ), and Geboes index (r = 0.298, p = 0.027 , p < 0.05 ). Overall accuracy of US for disease extension and activity was statistically significant ( p < 0.05 ). Conclusions. Our results suggest that US is a moderately accurate method for the assessment of disease activity and localization in patients with UC.

The Diagnostic Utility of Biochemical Markers and Intestinal Ultrasound Compared with Endoscopy in Patients with Crohn’s Disease and Ulcerative Colitis: A Systemic Review and Meta-Analysis

“…This is especially true as there are limitations on how quickly endoscopy can occur due to logistical reasons, such as patient preference, timing, availability, and fasting status. The utilization of IUS has been proposed as a valuable means for screening IBD, particularly in evaluating the anatomical extent of CD at initial diagnosis [ 33 , 34 ]. A previous meta-analysis investigating the diagnostic accuracy of IUS in identifying active CD reported combined sensitivity and specificity rates of 88% and 97%, respectively.…”

The role of intestinal ultrasound with colour Doppler in predicting the response to biologic therapy in inflammatory bowel disease patients

“…Gastroenterology Review the presence of severe ulcerative colitis that is actively developing [29]. The TRUST-UC trial is the broadest multicentre investigation concerning the application of intestinal ultrasound in patients with UC; in this study, BWT was verified as a US parameter for the identification of disease activity [30].…”

Novelties and Perspectives of Intestinal Ultrasound in the Personalised Management of Patients with Inflammatory Bowel Diseases—A Systematic Review

“…BWT, CDS, and loss of BWS are also used in UC to assess disease activity. Of these, the BWT is the most strongly correlated with endoscopic findings [41,[81][82][83]. Although 3 mm is considered the minimum value for an abnormal colon wall [54,84], statistical analysis in different studies has found different cut-offs with variate sensitivities and specificities (Table 6) [26,85,86].…”

“…In contrast, mesenteric fat hypertrophy, lymph nodes, loss of BWS, and loss of haustration showed only a fair agreement. The severity also depends on the IUS parameters, with higher disease activity exhibiting an increased risk of surgery [82,83,87]. Segmental accuracy is superior for IUS in the ascending and right colon, while CS can be used to assess the rectum [5,92].…”