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Systematic Scoring Analysis for Intestinal Inflammation in a Murine Dextran Sodium Sulfate-Induced Colitis Model
Published on: February 14, 2021
Single measurement of bowel wall thickness using intestinal ultrasonography in children with ulcerative colitis
Masano Otani1,2, Takeru Okuhira1,2, Atsushi Yoden2,3
1Department of Pediatrics, Osaka Saiseikai Suita Hospital, Suita, Osaka, Japan.
Insights
Bowel wall thickness (BWT) measured by intestinal ultrasonography is more effective than fecal calprotectin (FC) for assessing moderate colitis in children with ulcerative colitis (UC). This noninvasive method aids in managing pediatric UC patients.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Diagnostic Imaging Techniques
Background:
- Endoscopic monitoring is crucial for ulcerative colitis (UC) but invasive, particularly for pediatric patients.
- Noninvasive methods like intestinal ultrasonography (bowel wall thickness - BWT) and fecal calprotectin (FC) are valuable alternatives.
Purpose of the Study:
- To compare the efficacy of BWT and FC in evaluating disease activity in pediatric UC patients.
- To determine if BWT can serve as a reliable noninvasive marker for moderate colonic inflammation.
Main Methods:
- Retrospective analysis of BWT (mBWT, sBWT, saBWT) and FC levels in pediatric UC patients.
- Correlation of BWT and FC measurements with Mayo endoscopic subscore (MES) determined by colonoscopy.
Main Results:
- BWT and FC levels differed significantly between low (MES 0-1) and moderate (MES 2) inflammation.
- Sum of adjusted BWT (saBWT) demonstrated higher sensitivity and accuracy than FC in detecting moderate inflammation (MES 2).
- High agreement (89.4%) was observed between BWT measurements and MES 2.
Conclusions:
- Bowel wall thickness (BWT), especially saBWT, is a superior noninvasive indicator of moderate colonic inflammation in pediatric UC compared to FC.
- Intestinal ultrasonography offers a less invasive approach for managing pediatric UC patients.
Background:
Endoscopic monitoring of disease activity in patients with ulcerative colitis (UC) is important. However, frequent colonoscopic examinations are difficult to perform because of their invasiveness, especially in children. Bowel wall thickness (BWT) measurement using intestinal ultrasonography and fecal calprotectin (FC) measurement are useful noninvasive evaluation methods.
Methods:
We retrospectively analyzed BWT and FC levels and evaluated the Mayo endoscopic subscore (MES) using colonoscopy in pediatric patients with UC during the same period. The BWT was evaluated using the maximum BWT (mBWT), which was the maximum value of each colonic BWT; the sum of BWT (sBWT), which was the sum of each colonic BWT; and the sum of the adjusted BWT (saBWT), which was corrected using sBWT.
Results:
In 54 procedures from 40 patients, FC, mBWT, sBWT, and saBWT were significantly different between MES 0-1 and MES 2. The agreement between BWT and MES 2 was 193 out of 216 segments (89.4%). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FC were 68.8%, 84.2%, 64.7%, 86.5%, and 79.6% respectively, while those of saBWT were 81.2%, 89.5%, 76.5%, 91.9%, 87.0%, respectively.
Conclusions:
BWT in each colonic segment, particularly saBWT, was more useful than FC for detecting moderate colonic inflammation (MES 2) in pediatric patients with UC. Therefore, intestinal ultrasonography may be helpful in the less invasive management of pediatric patients with UC.
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