Evaluation of intestinal ultrasound for disease activity assessment in patients with inflammatory bowel disease: A cross-sectional study at a tertiary centre in Malaysia
Background: The use of intestinal ultrasound (IUS) in the management of inflammatory bowel disease (IBD) is emerging. We aim to determine the performance of IUS in the assessment of disease activity in IBD. Methods: This is a prospective cross-sectional study of IUS performed on IBD patients in a te...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | The Saudi Journal of Gastroenterology |
| Subjects: | |
| Online Access: | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2023;volume=29;issue=5;spage=300;epage=308;aulast=Lim |
| _version_ | 1797645346202976256 |
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| author | Kuan Yee Lim Raja Affendi Raja Ali Zhiqin Wong Faizah Mohd Zaki Juliana Fairuz Maktar Khairul Najmi Muhammad Nawawi |
| author_facet | Kuan Yee Lim Raja Affendi Raja Ali Zhiqin Wong Faizah Mohd Zaki Juliana Fairuz Maktar Khairul Najmi Muhammad Nawawi |
| author_sort | Kuan Yee Lim |
| collection | DOAJ |
| description | Background: The use of intestinal ultrasound (IUS) in the management of inflammatory bowel disease (IBD) is emerging. We aim to determine the performance of IUS in the assessment of disease activity in IBD.
Methods: This is a prospective cross-sectional study of IUS performed on IBD patients in a tertiary centre. IUS parameters including intestinal wall thickness, loss of wall stratification, mesenteric fibrofatty proliferation, and increased vascularity were compared with endoscopic and clinical activity indices.
Results: Among the 51 patients, 58.8% were male, with a mean age of 41 years. Fifty-seven percent had underlying ulcerative colitis with mean disease duration of 8.4 years. Against ileocolonoscopy, IUS had a sensitivity of 67% (95% confidence interval (CI): 41-86) for detecting endoscopically active disease. It had high specificity of 97% (95% CI: 82-99) with positive and negative predictive values of 92% and 84%, respectively. Against clinical activity index, IUS had a sensitivity of 70% (95% CI: 35-92) and specificity of 85% (95% CI: 70-94) for detecting moderate to severe disease. Among individual IUS parameters, presence of bowel wall thickening (>3 mm) had the highest sensitivity (72%) for detecting endoscopically active disease. For per-bowel segment analysis, IUS (bowel wall thickening) was able to achieve 100% sensitivity and 95% specificity when examining the transverse colon.
Conclusions: IUS has moderate sensitivity with excellent specificity in detecting active disease in IBD. IUS is most sensitive in detecting a disease at transverse colon. IUS can be employed as an adjunct in the assessment of IBD. |
| first_indexed | 2024-03-11T14:44:59Z |
| format | Article |
| id | doaj.art-14d8690c52144c3d8334d38947950644 |
| institution | Directory Open Access Journal |
| issn | 1319-3767 1998-4049 |
| language | English |
| last_indexed | 2024-03-11T14:44:59Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Saudi Journal of Gastroenterology |
| spelling | doaj.art-14d8690c52144c3d8334d389479506442023-10-30T12:01:04ZengWolters Kluwer Medknow PublicationsThe Saudi Journal of Gastroenterology1319-37671998-40492023-01-0129530030810.4103/sjg.sjg_531_22Evaluation of intestinal ultrasound for disease activity assessment in patients with inflammatory bowel disease: A cross-sectional study at a tertiary centre in MalaysiaKuan Yee LimRaja Affendi Raja AliZhiqin WongFaizah Mohd ZakiJuliana Fairuz MaktarKhairul Najmi Muhammad NawawiBackground: The use of intestinal ultrasound (IUS) in the management of inflammatory bowel disease (IBD) is emerging. We aim to determine the performance of IUS in the assessment of disease activity in IBD. Methods: This is a prospective cross-sectional study of IUS performed on IBD patients in a tertiary centre. IUS parameters including intestinal wall thickness, loss of wall stratification, mesenteric fibrofatty proliferation, and increased vascularity were compared with endoscopic and clinical activity indices. Results: Among the 51 patients, 58.8% were male, with a mean age of 41 years. Fifty-seven percent had underlying ulcerative colitis with mean disease duration of 8.4 years. Against ileocolonoscopy, IUS had a sensitivity of 67% (95% confidence interval (CI): 41-86) for detecting endoscopically active disease. It had high specificity of 97% (95% CI: 82-99) with positive and negative predictive values of 92% and 84%, respectively. Against clinical activity index, IUS had a sensitivity of 70% (95% CI: 35-92) and specificity of 85% (95% CI: 70-94) for detecting moderate to severe disease. Among individual IUS parameters, presence of bowel wall thickening (>3 mm) had the highest sensitivity (72%) for detecting endoscopically active disease. For per-bowel segment analysis, IUS (bowel wall thickening) was able to achieve 100% sensitivity and 95% specificity when examining the transverse colon. Conclusions: IUS has moderate sensitivity with excellent specificity in detecting active disease in IBD. IUS is most sensitive in detecting a disease at transverse colon. IUS can be employed as an adjunct in the assessment of IBD.http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2023;volume=29;issue=5;spage=300;epage=308;aulast=Limclinical activity indexendoscopic activity indexileocolonoscopyinflammatory bowel diseaseintestinal ultrasound |
| spellingShingle | Kuan Yee Lim Raja Affendi Raja Ali Zhiqin Wong Faizah Mohd Zaki Juliana Fairuz Maktar Khairul Najmi Muhammad Nawawi Evaluation of intestinal ultrasound for disease activity assessment in patients with inflammatory bowel disease: A cross-sectional study at a tertiary centre in Malaysia The Saudi Journal of Gastroenterology clinical activity index endoscopic activity index ileocolonoscopy inflammatory bowel disease intestinal ultrasound |
| title | Evaluation of intestinal ultrasound for disease activity assessment in patients with inflammatory bowel disease: A cross-sectional study at a tertiary centre in Malaysia |
| title_full | Evaluation of intestinal ultrasound for disease activity assessment in patients with inflammatory bowel disease: A cross-sectional study at a tertiary centre in Malaysia |
| title_fullStr | Evaluation of intestinal ultrasound for disease activity assessment in patients with inflammatory bowel disease: A cross-sectional study at a tertiary centre in Malaysia |
| title_full_unstemmed | Evaluation of intestinal ultrasound for disease activity assessment in patients with inflammatory bowel disease: A cross-sectional study at a tertiary centre in Malaysia |
| title_short | Evaluation of intestinal ultrasound for disease activity assessment in patients with inflammatory bowel disease: A cross-sectional study at a tertiary centre in Malaysia |
| title_sort | evaluation of intestinal ultrasound for disease activity assessment in patients with inflammatory bowel disease a cross sectional study at a tertiary centre in malaysia |
| topic | clinical activity index endoscopic activity index ileocolonoscopy inflammatory bowel disease intestinal ultrasound |
| url | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2023;volume=29;issue=5;spage=300;epage=308;aulast=Lim |
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