P308 Utility of bowel ultrasound in diagnosing disease activity in Crohn’s disease: Indian experience

• Published in: Journal of Crohn's and colitis 2019-01, Vol.13 (Supplement_1), p.S254-S254
• Main Authors: Kakkadasam Ramaswamy, P, Nagarajan, K V, Yelsangikar, A, Nagar, A, Bhat, N
• Format: Article
• Language: English
• ISSN: 1873-9946; 1876-4479
• DOI: 10.1093/ecco-jcc/jjy222.432

Abstract Background To assess the utility of bowel ultrasound (USG) in assessing Crohn’s disease activity in correlation with the simple-endoscopic score-CD (SES-CD) and Harvey–Bradshaw Index (HBI). Methods Patients with Crohn’s disease who underwent colonoscopy for assessment of disease activity also underwent a USG within a 2-week period without change in treatment. Colonoscopic disease activity was assessed by the SES-CD, SES-CD score of 3 and higher was defined as endoscopically active. Clinical disease activity was assessed by the HBI, and a HBI of 5 or more was defined as active disease. USG parameters assessed include bowel wall thickness (BWT), loss of bowel wall stratification (BWS), and Doppler activity. Doppler activity was evaluated semi-quantitatively by the Limberg score. Results Thirty-five patients were included in the study, 12 patients (34%) were in endoscopic remission, 7 patients (20%) had mild endoscopic activity, 6 patients (17%) had moderate endoscopic activity and 10 patients (29%) had severe endoscopic activity as per the SES-CD score. As per the HBI, 18 (51%) patients were in remission, 6 (17%) had mild, 8(23%) had moderate and 3 patients (9%) had severe disease. Sixteen (46%) patients had only small intestinal involvement, 13 (37%) ileocolonic and 6 (17%) colonic only. Median BWT was greater in patients with active disease when compared with those in endoscopic remission (6 mm vs. 2.45 mm, p < 0.01). BWT correlated with SES-CD (r = 0.455, p = 0.007) and HBI (r = 0.506, p = 0.002). BWS correlated with SES-CD (r = 0.432, p = 0.011) and HBI (r = 0.483, p = 0.003),Doppler correlated with SES-CD ( r = 0.494, p = 0.003) and HBI (r = 0.656, p = 0.001). Combining all 3 features (BWT, BWS, Doppler) correlated to SES-CD for active disease (r = 0.8, p = 0.009) and to HBI (r = 0.76, p = 0.04). Conclusions USG is a useful modality in assessing disease activity in Crohn’s disease. Bowel wall thickness, loss of stratification, and Doppler activity in the bowel wall correlate with endoscopic and clinical disease activity; and these features can be used in future studies assessing using USG to assess disease activity in Crohn's disease.