Role of intestinal ultrasound in ulcerative colitis: A systematic review

Table 10 Summary of studies correlating histology with intestinal ultrasound

Ref.	Study type	Number of patients	Treatment	IUS predictors	Histologic score	Correlation
Scholbach et al[66]	Single center, cross-sectional	12 pediatric UC	NA	Dynamic tissue perfusion measurement (DTPM)	No score Parameters: crypt abscess, neutrophils and lymphocytic invasion, wall edema	Wall perfusion on DTPM positively correlated with crypt abscess, neutrophils, and lymphocytic invasion. Negative correlation with wall edema
Romanini et al[42]	Prospective	18 UC, 15 CD	NS	Peak intensity, time to peak, regional blood volume and flow	Vascular density	High vascular density (CD 34+; > 265 vessels per high power field, 40 ×) correlated with IUS and CEUS (higher and earlier peak, higher blood flow and volume)
Kinoshita et al[54]	Prospective	156 UC	NS	BWT, CDI, BWS, wall echogenicity	Matt’s histological grade (1-5)	r = 0.35, P < 0.001
Sagami et al[57]	Single center, prospective, cross-sectional	53 UC	5-ASA, immunomodulators, budesonide, anti-TNF	BWT, BWS	Robarts histopathology index and Nancy histological index	Only BWT independently predicted histological activity in rectum; BWT > 4 highest sensitivity (95.5%), specificity 41.6%, and AUC 0.869 to predict NHI >1; specificity (76.2%) higher and sensitivity (59.1%) lower with Limberg’s score ≥ 2 (AUC: 0.812)
Goodsall et al[4]	Prospective	19 UC (29 paired data)	NS	Milan ultrasound criteria (MUC), BWT, CDI, BWS	NHI	Coefficient: 0.14, P = 0.011; MUC > 6.3 and/or FCP ≥ 100 μg/g for NHI > 1 sensitivity 88%, specificity 90%, PPV 95%, NPV 57%

PPV: Positive predictive value; NPV: Negative predictive value; UC: Ulcerative Colitis; CD: Crohn’ disease; CDI: Color Doppler intensity; BWT: Bowel wall thickness; AUC: Area under the curve; NHI: Nancy histologic index; BWS: Bowel wall stratification; IUS: Intestinal ultrasound.