The Role of Ultrasound in Assessment of Disease Activity in Inflammatory Bowel Disease Patients

Abstract Aim This study aim to evaluate the role of Ultrasound in assessment of disease activity in Inflammatory Bowel Disease patients (IBD). Patients and Methods The was performed at Radiology Department and involved a diagnosed cases of Inflammatory Bowel Diseases referred from the Gastroenterology Unit, Ain Shams University Hospitals. A total Thirty six patients inflammatory bowel disease patients (Ulcerative colitis and Chron's disease) were subjected to Intestinal Ultrasound assessment (IUS), Fecal Calprotectin (CP) analysis and calculation of the Clinical Activity Indices. Twenty five patients were subjected to Endoscopic Activity Assessment. Intestinal Ultrasound (IUS) parameters including intestinal wall thickness (BWT) and intestinal bowel wall vascularity, were compared with Endoscopic Activity, Fecal Calprotectin levels (CP) and Clinical Activity Indices. Results Among the thirty-six patients, there were fourteen diagnosed Chron`s cases (38.9%) and twenty-two Ulcerative Colitis cases (61.1%). Roc curve analysis revealed the ability of the ultrasound bowel wall thickness (BWT) to differentiate between mild and moderate disease activity in IBD patients with sensitivity of 90.91% and specificity of 100.0%, with area under curve (AUC) of 0.909 using the endoscopic activity as a gold standard. A statistically significant difference was found between the (BWT) measurements and Simple Endoscopic score (SES-CD) (P = 0.002) as well as between the (BWT) measurements and Endoscopic Mayo score (P = 0.001). A statistically significant correlation was found between the fecal CP levels and Intestinal bowel wall thickness among Ulcerative colitis and Chron's patients with (r = 0.708, P < 0.001) and (r = 0.736, P < 0.01) respectively. There was also statistically significant difference between the Clinical Activity Indices (Harvey-Bradshaw Index and Partial Mayo Score) and the (BWT) among both the Chron's and Ulcerative colitis patients with P-value (0.004) and (0.001) respectively. A statistically significant difference was found between Doppler (Limberg Score) and SES-CD endoscopic activity score (p = 0.009) as well as between Doppler (Limberg Score) and Endoscopic activity Mayo score (p = 0.005). Conclusion The results of the study suggest that the Bowel Wall Thickness (BWT) and Color Doppler Signal could serve as non-invasive parameters of detecting IBD activity. Intestinal US could be one of the promising methods for the detection of the disease activity as well as monitoring of IBD patients.