P246 2D Shear Wave Elastography as novel tool for the assessment of disease severity in patients with IBD
Demir, E.(1);Cindoruk, M.(2);Karataş, A.(2);Karakan, T.(2)*;Kılıç, G.(2);Ergin, M.(2);Cerit, M.N.(3);Ozbas, C.(4);Oktar, S.O.(3);Ucar, M.(2);Gulbahar, O.(5);Demir, B.(1);
(1)Gazi University, Internal Medicine, Ankara, Turkey;(2)Gazi University, Gastroenterology, Ankara, Turkey;(3)Gazi University, Radiology, Ankara, Turkey;(4)Gazi University, Public Health, Ankara, Turkey;(5)Gazi University, Biochemistry, Ankara, Turkey;
Intestinal Ultrasound (IUS) is a non-invasive modality capable of assessing disease activity in IBD. IUS is reliable, patient-friendly, and allows frequent monitoring of disease activity. Elastography is a measure of tissue stiffness, that is usually studied for the evaluation of intestinal fibrosis in previous studies. However, the addition of elastography to standard IUS for assessing disease severity is still limited. Here we present novel data on the diagnostic value of 2D shear-wave elastography (SWE) in the evaluation of disease severity in patients with IBD.
In this prospective descriptive study performed in a single center, consecutive 38 patients with UC and 22 CD were included. Disease activities of UC patients were evaluated by Mayo score and Endoscopic Activity Index (EAI) while Crohn’s Disease Activity Index (CDAI) and Harvey-Bradshaw Index (HBI) evaluated disease activation of CD patients. The bowel wall thickness (BWT) and Limberg score were also measured. The intestinal segment held by an experienced single operator with the 2D-SWE technique was estimated, and its value in kilopascal (kPa) was recorded.
A statistically significant correlation was found between the stiffness values obtained with SWE, BWT and disease activity scores. Tissue stiffness (kPa) was correlated with HBI (r=0.772, p<0.01), CDAI (r=0.817, p<0.01), C-reactive protein (r=0.503, p=0.02) in CD. In UC, tissue stiffness was correlated with Mayo score (r=0.491, p=0.002), EAI (r=0.481, p=0.003) and C-reactive protein (r=0.423, p=0.009). The correlation of BWT and tissue stiffness was (r=0.797, p<0.05 and 0.698, p<0.05 in CD and UC, respectively). Limberg score was correlated with tissue stiffness values (r=0.743, p<0.05 and r=801, p<0.01 in CD and UC, respectively). The duration of illness was correlated with tissue stiffness values in patients with UC (r=0.665, p<0.05), however it was not correlated in CD patients.
2D-SWE is a promising tool in assessing disease activity in patients with CD and UC. Further studies are needed to understand the additive value of elastography in the clinical assessment of patients with IBD.