医学
溃疡性结肠炎
胃肠病学
钙蛋白酶
内科学
超声波
前瞻性队列研究
组织学
试验预测值
内窥镜检查
结肠炎
炎症性肠病
放射科
疾病
作者
Thomas M Goodsall,Alice S Day,Jane M. Andrews,Andrew Ruszkiewicz,Christopher Ma,Robert V Bryant
出处
期刊:Inflammatory Bowel Diseases
[Oxford University Press]
日期:2023-03-16
摘要
Abstract Background Beyond endoscopic remission, histological remission in ulcerative colitis (UC) is predictive of clinical outcomes. Intestinal ultrasound (IUS) may offer a noninvasive surrogate marker for histological activity; however, there are limited data correlating validated ultrasound and histological indices. Aim Our aim was to determine the correlation of IUS activity in UC with a validated histological activity index. Methods Twenty-nine prospective, paired, same-day IUS/endoscopy/histology/fecal calprotectin (FC) cases were included. Intestinal ultrasound activity was determined using the Milan Ultrasound Criteria, histological activity using the Nancy Histological Index, endoscopic activity using Mayo endoscopic subscore and Ulcerative Colitis Endoscopic Index of Severity, and clinical activity using the Simple Clinical Colitis Activity Score. Results Histological activity demonstrated a significant linear association with overall IUS activity (coefficient 0.14; 95% CI, 0.03-0.25; P = .011). Intestinal ultrasound activity was also significantly associated with endoscopic activity (0.32; 95% CI, 0.14-0.49; P < 0.001), total Mayo score (0.31; 95% CI, 0.02-0.60; P = .036) but not FC (0.10; 95% CI, −0.01 to 0.21; P = .064) or clinical disease activity (0.04; 95% CI, −0.21 to 0.28; P = .768). A composite of IUS and FC showed the greatest association (1.31; 95% CI, 0.43-2.18; P = .003) and accurately predicted histological activity in 88% of cases (P = .007), with sensitivity of 88%, specificity 80%, positive predictive value 95%, and negative predictive value 57%. Conclusions Intestinal ultrasound is an accurate noninvasive marker of histological disease activity in UC, the accuracy of which is further enhanced when used in composite with FC. This can reduce the need for colonoscopy in routine care by supporting accurate point-of-care decision-making in patients with UC.
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