Images of colonic real-time tissue sonoelastography correlate with those of colonoscopy and may predict response to therapy in patients with ulcerative colitis

Abstract

BackgroundReal-time tissue sonoelastography (EG) is a new non-invasive technique that visualizes differences in tissue strain. We evaluated the usefulness of EG in patients with ulcerative colitis (UC) by investigating the association between EG and colonoscopic findings and disease activity.MethodsThirty-seven UC patients undergoing EG and colonoscopy were invited to enroll. EG findings were classified as normal, homogeneous, random, or hard, and colonoscopic findings as normal, mucosal edema and erosion, punched-out ulcer, and extensive mucosal abrasion. Clinical findings were evaluated using clinical activity index (CAI) scores for each patient at colonoscopy.ResultsOn EG, 10 cases were classified as normal, 11 as homogeneous, 6 as random, and 10 as hard. EG findings showed a significant correlation those of colonoscopy (p < 0.001). Seven of 10 (70%) normal-type patients were in the remission phase, while all 6 random-type patients were in the active phase. Among active-phase patients, 4 of 7 (57%) homogeneous-type patients responded to steroid or leukocytapheresis therapy, while 3 of 6 (50%) random-type patients required treatment with cyclosporine. Three of 10 (30%) hard-type patients required colectomy.ConclusionsIn this small series, EG findings reflected colonoscopic findings and correlated with disease activity among patients with UC.

Strain elastography in placental dysfunction: placental elasticity differences in normal and preeclamptic pregnancies in the second trimester

“…Pathologic examinations of placentas from preeclamptic pregnancies show placental infarcts, sclerotic changes of arteries, intervillous thrombosis, increased villous inflammation, and low placental weight [18,33]. Similar mechanism has been noted in previous studies investigating the role of SE in cases of liver fibrosis, hepatitis, cirrhosis, and pancreatitis [5,9,10,23,34]. We speculate that these histologic changes of the placenta may cause an increase in stiffness of the placenta [5,10].…”

“…Real-time sonoelastography is used for benign and malignant masses of the breast, thyroid, prostate, and kidney as well as for the assessment of liver fibrosis [3][4][5][6][7][8]. Endoscopic elastography is a method for the characterization of pancreatic lesions, lymph nodes, and gastrointestinal wall layers especially in the anorectal region [9,10]. Applications for this technique in gynecology and obstetrics have recently been documented [11,12].…”

Particularities of Crohn’s disease in pediatric patients: current status and perspectives regarding imaging modalities

“…The role of elastography has been explored as well in order to determine active inflammation versus fibrotic strictures [128][129][130], both causing alterations in the elasticity of the affected tissues [131]. Both the endosonographic and the percutaneous approach are promising [132,133].…”

Usefulness of Strain Elastography, ARFI Imaging, and Point Shear Wave Elastography for the Assessment of Crohn Disease Strictures

“…ARFI imaging score. A , Score 1, thick bowel wall displayed as predominantly bright; B , Score 2, thick bowel wall displayed as predominantly bright with a few dark portions; C , Score 3, almost equal proportions of bright and dark; D , Score 4, thick bowel wall displayed as predominantly dark with a few bright portions; E , Score 5, thick bowel wall displayed as almost completely dark …”