P0388 Can intestinal ultrasound guide us in the treatment of inflammatory bowel disease?

Abstract Background Intestinal Ultrasonography (IUS) is a useful method for monitoring inflammatory bowel disease. The role of Shear Wave Elastography (SWE) and the relationship with other parameters indicating activity are not yet well understood. Methods The aim was to describe the ultrasound characteristics observed in a cohort of patients with Crohn’s disease (CD) and the changes in therapeutic attitude derived from the results of this imaging test. To evaluate the usefulness of SWE in patients with intestinal strictures to detect fibrosis in comparison with analytical and ultrasound parameters of inflammatory activity. We conducted a single-center, retrospective, observational study of a baseline study including IUS examinations performed in CD patients between May 2022 and February 2023. Results We included 63 IUS in CD patients (60.9% male; mean age 43 ± 17 years). The mean HBI-score was 2.77 (± 2.6). A change in therapeutic approach was made in 32.8% of cases following IUS. Stricture was found in 22 IUS (34.9%), with a mean length of 5.6 ± 2.59 cm. Fat wrapping was observed in 40.9% of cases, and loss of wall stratification in 9.1%. Median SWE of the stricture was 9.05. Calprotectin is directly related to the Limberg scale (p<0.001) and indirectly with the SWE value (p<0.05). Inverse correlation between Limberg scale and SWE value (p<0.05) was observed. Conclusion intestinal ultrasonography facilitates a proactive monitoring in CD because immediate changes in therapeutic approach can be made. The combination of the Limberg scale and the SWE value allow the definition of intestinal strictures. Comparative studies are needed to clarify the usefulness in predicting the degree of fibrosis.