Clinical and translational gastroenterology · 2025
Relationship of Intestinal Ultrasound With Clinical, Biochemical, and Endoscopic Disease Severity in Acute Severe Ulcerative Colitis: A Blinded, Prospective Study.
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Gu Phillip, Ziring David, Khanna Puja V, Ahmed Waseem, Vasiliauskas Eric, Yarur Andres, Targan Stephan, McGovern Dermot P B, Rabizadeh Shervin, Fleshner Phillip, Abreu Maria T, Melmed Gil Y
Аннотация
INTRODUCTION: The utility of intestinal ultrasound (IUS) for acute severe ulcerative colitis (ASUC) is understudied. We correlated IUS to clinical, biochemical, and endoscopic disease severity in ASUC.
METHODS: In a blinded, prospective study of 20 ASUC subjects, we analyzed standard IUS parameters (bowel wall thickening, vascular flow, wall stratification) and UC IUS indices (International Bowel Ultrasound Segmental Activity Score (IBUS-SAS), Milan-UC, UC-IUS) alongside modified Mayo symptoms scores, C-reactive protein (CRP), albumin, and UC Endoscopic Index of Severity (UCEIS). Spearman correlations were performed (rs). Area under the curve (AUC) determined utility of IUS for detecting severe endoscopic disease.
RESULTS: All IUS indices correlated with stool frequency (rs: 0.45-0.58, P < 0.001), CRP (rs: 0.56-0.59, P < 0.02), and UCEIS (rs: 0.54-0.69, P < 0.03). IBUS-SAS (AUC 0.91) and Milan-UC (AUC 0.93) outperformed IUS-UC (AUC 0.82) for detecting UCEIS ≥5. Loss of bowel wall stratification correlated strongest with CRP (rs: 0.8, P = 3.61e -8 ) and UCEIS (rs: 0.50, P = 0.047).
DISCUSSION: IUS offers an accurate and noninvasive method to evaluate ASUC severity and treatment response.
METHODS: In a blinded, prospective study of 20 ASUC subjects, we analyzed standard IUS parameters (bowel wall thickening, vascular flow, wall stratification) and UC IUS indices (International Bowel Ultrasound Segmental Activity Score (IBUS-SAS), Milan-UC, UC-IUS) alongside modified Mayo symptoms scores, C-reactive protein (CRP), albumin, and UC Endoscopic Index of Severity (UCEIS). Spearman correlations were performed (rs). Area under the curve (AUC) determined utility of IUS for detecting severe endoscopic disease.
RESULTS: All IUS indices correlated with stool frequency (rs: 0.45-0.58, P < 0.001), CRP (rs: 0.56-0.59, P < 0.02), and UCEIS (rs: 0.54-0.69, P < 0.03). IBUS-SAS (AUC 0.91) and Milan-UC (AUC 0.93) outperformed IUS-UC (AUC 0.82) for detecting UCEIS ≥5. Loss of bowel wall stratification correlated strongest with CRP (rs: 0.8, P = 3.61e -8 ) and UCEIS (rs: 0.50, P = 0.047).
DISCUSSION: IUS offers an accurate and noninvasive method to evaluate ASUC severity and treatment response.