Intestinal Ultrasound Combined with Blood Inflammatory Markers Is a More Efficient Tool in Evaluating Severity of Crohn's Disease: A Pilot Study

Huaying Fang; Jie Liu; Kai Qian; Xuemei Xu; Zhaolong Li; Li Xie; Menghan Sun; Song Wang; Jiaqin Xu; Chaolan Lv; Bo Wang; Weiyong Liu; Gengqing Song; Yue Yu

doi:10.1155/2023/2173396

Intestinal Ultrasound Combined with Blood Inflammatory Markers Is a More Efficient Tool in Evaluating Severity of Crohn's Disease: A Pilot Study

Gastroenterol Res Pract. 2023 Nov 8:2023:2173396. doi: 10.1155/2023/2173396. eCollection 2023.

Authors

Huaying Fang¹, Jie Liu¹, Kai Qian¹, Xuemei Xu¹, Zhaolong Li², Li Xie¹, Menghan Sun¹, Song Wang³, Jiaqin Xu¹, Chaolan Lv¹, Bo Wang¹, Weiyong Liu⁴, Gengqing Song⁵, Yue Yu¹

Affiliations

¹ Department of Gastroenterology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China.
² Medical Imaging Center, The First Affiliated Hospital of Anhui Medical University North District, Hefei, Anhui 230011, China.
³ Department of Endoscopy, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200235, China.
⁴ Department of Ultrasound Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China.
⁵ Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109, USA.

Abstract

Background and aims: Intestinal ultrasound (IUS) is considered a nonirradiating, noninvasive, well-tolerated, and valuable tool for objectively assessing Crohn's disease (CD) activity. However, there is no widely accepted intestinal ultrasound scoring system. This study is aimed at evaluating the efficacy of IUS key parameters, the International Bowel Ultrasound Activity Score (IBUS-SAS), and IBUS-SAS combined with blood inflammatory markers in assessing CD activity.

Methods: 40 CD patients were reviewed in this retrospective study and were divided into the moderate-severe group (n = 25) and nonmoderate-severe group (n = 15) based on a simplified endoscopic score of Crohn's disease (SES-CD). Double-balloon enteroscopy/colonoscopy were reviewed by three gastroenterologists. A transabdominal ultrasound was performed by two ultrasound specialists. Blood inflammatory markers were measured from morning samples.

Results: In evaluating moderate to severe CD patients, (1) IBUS-SAS had a good predictive effect with an area-under-the-curve (AUC) of 0.855 (P < 0.001); (2) IUS key parameters (including BWT, CDS, BWS, and I-fat) yielded good predictive effects with AUC of 0.811, 0.731, 0.724, and 0.747, respectively (P < 0.001); (3) blood inflammatory markers (including ESR, CRP, PLR, MLR, and NLR) also had good predictive effects with AUC of 0.771, 0.837, 0.728, 0.743, and 0.775, respectively (P < 0.001); (4) IBUS-SAS combined with ESR and CRP exerted the best predictive effect with the highest AUC of 0.912 (95% CI: 0.823-1.000), and the sensitivity and specificity were 88.0% and 80.0%, respectively (P < 0.001).

Conclusion: IBUS-SAS combined with ESR and CRP is a more efficient tool than IBUS-SAS alone or inflammatory markers alone in evaluating CD patients with moderate to severe disease activity.