High-frequency mini-probe ultrasound imaging permits trans-mural cross-sectional imaging of the colorectal wall.
In ulcerative colitis, prognosis is dependent on the severity of mucosal inflammatory change.
Accurate assessment of disease activity is required to optimize medical therapy.
Furthermore, predicting relapse of disease using conventional endoscopic, histopathological and clinical criteria has not proven reliable.
Dr David Hurlstone and colleagues evaluated the correlation of high-frequency mini-probe imaging with standardized measures of severity.
The research team assessed clinical, endoscopic and histopathological severity.
|Kappa coefficient between Tsuga criteria I/II and Matts grade 1/2 was 0.8 for rectal disease|
|European Journal of Gastroenterology & Hepatology|
High-frequency ultrasound images were obtained from the caecum to rectum in 200 patients.
Tsuga colorectal ultrasound criteria were then compared to the endoscopic Baron score, Seo activity score and Matts histopathological grade.
For rectal disease, the team found that the kappa coefficient between Tsuga criteria I/II and Matts grade 1/2 was 0.8, for Tsuga class IIIa/b.
The researchers noted that kappa coefficient between Tsuga criteria I/II and Matts grade 1/2 was 0.6 for Tsuga class IVa/b and 0.5 for Matts grade 3a/b.
The team observed a kappa coefficient between Tsuga class I/II and Matts grade1/2 of 0.8 with colonic imaging.
Tsuga class IIIa-IIIb/IVa-IVb as compared to Matts grade 3a-3b/4 yielded kappa coefficients of 0.5 and 0.6, respectively.
In the rectum both the total wall thickness, mucosa and submucosa were significantly thicker in Matts grade 3b and 4 disease vs Matts grade 1/2.
The team noted a significant increase in colonic total wall thickness was observed between Matts score 4 and Tsuga grade 1 to 3a disease.
Dr Hurlstone's team concludes, “High-frequency ultrasound is a valid adjunctive 'tool' for the trans-mural assessment of the colorectal wall in ulcerative colitis.”
“This technique may aid in the initial diagnosis, and ongoing chronic management of disease.”