Diagnostic accuracy of ultrasonography in comparison with colonoscopy for diagnosing of ulcerative colitis

Abstract

Aim: To evaluate diagnostic accuracy of ultrasonography in comparison with colonoscopy as gold standard for diagnosing of ulcerative colitis (UC). Method: In this prospective study, 114 participants who attended in Ahvaz Imam Hospital during March 2014 to February 2015 included. The participants divided into 2 groups: group A as 64 UC patients (flare or new case) and 50 participants as control group who attend for colorectal cancer screening or evaluation of rectorrhagia. All of the participants obtained a Trans abdominal ultrasonography after 8hours fasting and evaluated for colonic thickness in any involved region, loss of compressibility, peristaltic movement, mesenteric lymph nodes enlargement and presence or absence of ascites, fat stranding or stratification. Results: Ultrasonography sensitivity for diagnosing of moderate to severe UC in comparison with colonoscopy was between 52.56 to 86.36% based on different factors such as new onset or active disease, BMI, gender and region of involvement. In all of the situations the specificity was 100%. The sensitivity for diagnosing new cases of UC and pancolitis were 86.36% and 76.67% respectively and these figures were less among cases with BMI more than 25. The colonic wall thickness in new cases of UC (6.4±1.3mm) was significantly more than wall thickness among disease flare up (5.5±1.7mm) (P=0.02) and also average colon thickness in UC group (average 5.9mm , range 2-9mm) was significantly more than control group (average 3.3mm, range 3-4mm). Conclusion: The findings of current study prove that ultrasonography is not an ideal tool for evaluation of UC patients because its results could affect by several factors such as BMI and region of involvement.

The role of Trans-abdominal Ultrasound in Assessing Disease Activity and Severity in Ulcerative Colitis

“…On the other side, the results of the current work disagree with Hajiani et al [17] who found that colonic mural thickness among new cases of ulcerative colitis was significantly more than cases who diagnosed as UC flare up and concluded that ultrasonography is not an ideal tool for evaluation of UC patients because its results could be affected by several factors such as body mass index [BMI] and region of involvement. Different phases of the disease included in their study and current work could explain this controversy.…”

“…Oral administration of agents such as polyethylene glycol may improve image quality and diagnostic accuracy [7] . BUS for IBD often requires high frequency [5][6][7][8][9][10][11][12][13][14][15][16][17] linear array probes to increase the resolution and to allow adequate assessment of the intestinal wall [8] . Doppler assessment provides additional vascular information and may assist in differentiating predominantly inflammatory from fibrostenotic lesions.…”