Journal of ultrasound · 2026
Evaluating the correlation of intestinal ultrasound and fecal calprotectin with endoscopic severity scores in assessing disease activity in ulcerative colitis patients.
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Parihar Shishirendu, Yadav Dawesh Prakash, Verma Ashish, Shukla Sunit Kumar, Tiwari Anurag Kumar, Kumar Vinod, Kukreja Karan, Shah Akash, Mittal Ishan, Bassi Nitesh
Аннотация
BACKGROUND AND AIMS: Ulcerative colitis (UC) is a chronic inflammatory bowel disease. Noninvasive markers, including fecal calprotectin (FC) and intestinal ultrasound (IUS), have emerged as promising tools for assessing UC activity. To establish the correlation between noninvasive test IUS and fecal calprotectin with the gold standard invasive test UCEIS for assessing disease activity in patients with UC.
MATERIALS AND METHODS: Sixty UC patients were enrolled, and comprehensive demographic, clinical, and biochemical data were collected. FC levels, IUS findings, UCEIS scores, and endoscopic Mayo scores were analyzed.
RESULTS: A significant correlation was noted in between fecal calprotectin and bowel wall thickness (BWT) in descending colon (r = 0.423, p = 0.001) and the rectosigmoid (r = 0.306, p = 0.017). Further strong positive correlation was observed between UCEIS and BWT in the descending colon (r = 0.653, p = 0.001) and rectosigmoid (r = 0.406, p = 0.001). The combination of BWT > 3 mm or FC > 250 μg/g demonstrated high sensitivity (92.3%) for detecting active disease, while higher cutoffs showed improved specificity. These findings suggest that IUS and FC may serve as reliable noninvasive tools for assessing disease activity in moderate-to-severe UC. In contrast, the combination of BWT > 4 mm or FC > 500 demonstrated lower sensitivity (68.9%) but increased specificity (94.2%), making it a more precise but less sensitive indicator.
CONCLUSION: FC and IUS offer valuable insights into disease activity and may complement endoscopic evaluation. Early utilization of IUS with FC pre- and post-treatment initiation accurately correlates well with endoscopic disease activity and improvement in moderate-to-severe UC, suggesting their potential as diagnostic and prognostic tools for close monitoring and treatment optimization.
MATERIALS AND METHODS: Sixty UC patients were enrolled, and comprehensive demographic, clinical, and biochemical data were collected. FC levels, IUS findings, UCEIS scores, and endoscopic Mayo scores were analyzed.
RESULTS: A significant correlation was noted in between fecal calprotectin and bowel wall thickness (BWT) in descending colon (r = 0.423, p = 0.001) and the rectosigmoid (r = 0.306, p = 0.017). Further strong positive correlation was observed between UCEIS and BWT in the descending colon (r = 0.653, p = 0.001) and rectosigmoid (r = 0.406, p = 0.001). The combination of BWT > 3 mm or FC > 250 μg/g demonstrated high sensitivity (92.3%) for detecting active disease, while higher cutoffs showed improved specificity. These findings suggest that IUS and FC may serve as reliable noninvasive tools for assessing disease activity in moderate-to-severe UC. In contrast, the combination of BWT > 4 mm or FC > 500 demonstrated lower sensitivity (68.9%) but increased specificity (94.2%), making it a more precise but less sensitive indicator.
CONCLUSION: FC and IUS offer valuable insights into disease activity and may complement endoscopic evaluation. Early utilization of IUS with FC pre- and post-treatment initiation accurately correlates well with endoscopic disease activity and improvement in moderate-to-severe UC, suggesting their potential as diagnostic and prognostic tools for close monitoring and treatment optimization.