P0310 Intestinal Ultrasound parameters correlate with endoscopic findings in patients with post-operative Crohn’s disease.

Abstract Background In patients with Crohn’s disease (CD) and ileocecal resection, colonoscopy remains the gold-standard for detecting post-operative recurrence (POR). Intestinal ultrasound (IUS) is non-invasive, patient-friendly, with high accuracy for the detection of bowel inflammation. The aim of the present study was to investigate the correlation between post-operative endoscopic findings and those of IUS in patients with CD. Methods We analyzed data from CD patients with ileocecal resection who underwent colonoscopy and IUS for follow up. Post-operative endoscopic recurrence (ER) was defined as Rutgeert’s score (RS)≥i2b. The following IUS parameters were analyzed: bowel wall thickness (BWT), bowel wall stratification (BWS), modified Limberg score for the assessment of bowel wall hyperemia (BWH) and neo-terminal ileum peristalsis. Linear and binary logistic regressions were used to identify associations between RS and IUS parameters. SPSS-23 was used for the statistical analysis with a threshold of P=0.05 for statistical significance. Results In total, 44 patients [29 male, median age (SD): 40 (14.7) years] underwent IUS 42 [2-126] months following ileocecal resection. Thirty-eight (86%) patients were on treatment [infliximab 10 (23%), adalimumab 9 (21%), ustekinumab 11 (25%), vedolizumab 4 (9%), ozanimod 1 (2%) azathioprine 1 (2%), methotrexate 1 (2%)] and 7 (16%) patients were on no treatment. Endoscopic recurrence was detected in 52% of patients. Higher RS was associated with increased BWT, absence of peristalsis in the neo-TI and loss of BWS (P=0.007, P=0.001 and P=0.028 respectively). In multivariate analysis a higher RS was independently associated with the absence of peristalsis in the neo-terminal ileum (P=0.019). A tendency for a positive correlation between RS and ΒWT (P = 0.071) was also observed. RS≥i2b was significantly correlated with loss of BWS (P=0.045), absence of peristalsis (P=0.027) and a tendency was observed with BWT(P=0.081). RS≥i3 was significantly correlated with absence of peristalsis in the neo-TI (P= 0.001), BWT>3mm (P= 0.041), while a tendency was observed with modified Limberg score≥2 (P= 0.082). Conclusion IUS parameters correlate with RS in patients with post-operative CD. IUS may be a valuable monitoring tool for the assessment of POR in CD. Larger prospective studies are needed to determine cut-off values of sonographic parameters that may accurately predict post-operative recurrence of CD.