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P154 Development of a novel ultrasound based score for assessing disease activity in ulcerative colitis: preliminary results

P. Kakkadasam Ramaswamy*1, A. Yelsangikar1, K. V. Nagarajan1, A. Nagar1, N. Bhat1

1Aster CMI Hospital, Department of Gastroenterology, Liver Diseases and Clinical Nutrition, Bangalore, India

Background

Colonoscopy based scores are the gold standard for assessing disease activity in ulcerative colitis (UC). The aim of this study was to develop a new bowel ultrasound (USG) based score for assessing disease activity in UC and to assess its correlation with Mayo endoscopic score (MES).

Methods

Patients who underwent colonoscopy for assessment of disease activity also underwent USG within 2 weeks. Endoscopic activity was graded with MES; clinical disease activity was assessed using the Total Mayo Score (TMS). All assessments were performed for the rectum, sigmoid, descending, transverse, and ascending colon and caecum. A novel score based on Colonic wall thickness (CWT), loss of bowel wall stratification, Doppler activity (D) was calculated for each segment and correlated to the MES.

USG based score.

Results

A total of 102 colonic segments were analysed. Median CWT was lower in patients with MES 0-1 when compared with MES 2-3 (3 mm vs. 4.1 mm, p = 0.01). The ultrasound score (USS) was calculated for each colonic segment and correlated to the MES for that particular segment. USS correlation to MES for each segment was as follows: caecum (r = 0.95, p = 0.0001); ascending colon (r = 0.9, p = 0.001), transverse colon (r = 0.955, p = 0.0001), descending colon (r = 0.845, p = 0.001), sigmoid colon (r = 0.816, p = 0.0001), rectum (r = 0.761, p = 0.001). The USS for sigmoid colon correlated with the overall MES (r = 1, p = 0.0001), and Total Mayo Score (r = 0.918, p = 0.0001).

Conclusion

The novel ultrasound score has excellent correlation with MES. USS assessment of the sigmoid colon correlates with overall endoscopic activity and the Total Mayo score.