Images of colonic real-time tissue sonoelastography correlate with those of colonoscopy and may predict response to therapy in patients with ulcerative colitis

Daisuke Ishikawa,Osamu Maeda,Naoki Ohmiya,Masanao Nakamura,Osamu Watanabe,Emad M El-Omar,Takafumi Ando,Yoshiki Hirooka,Kazuhiro Ishiguro,Nobuyuki Miyake,Ryoji Miyahara,Hidemi Goto

doi:10.1186/1471-230x-11-29

Daisuke Ishikawa, Osamu Maeda + Show 10 more

Open Access

https://doi.org/10.1186/1471-230x-11-29

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Abstract

BackgroundReal-time tissue sonoelastography (EG) is a new non-invasive technique that visualizes differences in tissue strain. We evaluated the usefulness of EG in patients with ulcerative colitis (UC) by investigating the association between EG and colonoscopic findings and disease activity.MethodsThirty-seven UC patients undergoing EG and colonoscopy were invited to enroll. EG findings were classified as normal, homogeneous, random, or hard, and colonoscopic findings as normal, mucosal edema and erosion, punched-out ulcer, and extensive mucosal abrasion. Clinical findings were evaluated using clinical activity index (CAI) scores for each patient at colonoscopy.ResultsOn EG, 10 cases were classified as normal, 11 as homogeneous, 6 as random, and 10 as hard. EG findings showed a significant correlation those of colonoscopy (p < 0.001). Seven of 10 (70%) normal-type patients were in the remission phase, while all 6 random-type patients were in the active phase. Among active-phase patients, 4 of 7 (57%) homogeneous-type patients responded to steroid or leukocytapheresis therapy, while 3 of 6 (50%) random-type patients required treatment with cyclosporine. Three of 10 (30%) hard-type patients required colectomy.ConclusionsIn this small series, EG findings reflected colonoscopic findings and correlated with disease activity among patients with UC.

Highlights

Real-time tissue sonoelastography (EG) is a new non-invasive technique that visualizes differences in tissue strain
Real-time tissue sonoelastography (EG) is a new technique that visualizes the differences in tissue strain produced by freehand compression during routine US
EG and colonoscopic findings Application of the US ventrally to image the ventral part of the colon obviated the air barrier to US transmission, and good EG- and B-mode images were obtained in all patients

Summary

Introduction

Real-time tissue sonoelastography (EG) is a new non-invasive technique that visualizes differences in tissue strain. We evaluated the usefulness of EG in patients with ulcerative colitis (UC) by investigating the association between EG and colonoscopic findings and disease activity. One candidate is transabdominal ultrasonography (US), a useful and noninvasive diagnostic procedure which is used in the examination of hepatobiliary and pancreatic diseases. The recent marked improvement in ultrasound devices allows the use of US in the diagnosis of gastrointestinal. Real-time tissue sonoelastography (EG) is a new technique that visualizes the differences in tissue strain produced by freehand compression during routine US. EG has been reported to be useful in the evaluation of lymph nodes and the diagnosis of pancreatic and liver diseases [10,11]. To demonstrate its feasibility in intestinal fibrosis, for example, Kim et al used EG in an animal model of IBD, and suggested the feasibility of translating this imaging technique directly to human subjects for both diagnosis and monitoring [12]

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