Kenji Kinoshita1, Takehiko Katsurada2, Mutsumi Nishida3,4, Satomi Omotehara3,4, Reizo Onishi2, Katsuhiro Mabe5, Aki Onodera6, Mami Sato6, Kazunori Eto7, Mitsutoshi Suya8, Atsuo Maemoto9, Toru Hasegawa10, Junji Yamamoto11, Daiki Mitsumori12, Shinji Yoshii13, Kota Ono14, Naoya Sakamoto2. 1. Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7 Kita-ku, Sapporo, 060-8638, Japan. sugarspice0118@yahoo.co.jp. 2. Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7 Kita-ku, Sapporo, 060-8638, Japan. 3. Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan. 4. Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan. 5. Department of Gastroenterology, National Hospital Organization Hakodate Hospital, Hakodate, Japan. 6. Department of Clinical Laboratory, Tomakomai City Hospital, Tomakomai, Japan. 7. Department of Gastroenterology, Tomakomai City Hospital, Tomakomai, Japan. 8. Department of Clinical Laboratory, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan. 9. Inflammatory Bowel Disease Center, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan. 10. Department of Clinical Laboratory, Ohguro Gastroenterological Hospital, Sapporo, Japan. 11. Ohguro Gastroenterological Hospital, Sapporo, Japan. 12. Department of Clinical Laboratory, Sapporo Medical Center NTT EC, Sapporo, Japan. 13. Department of Gastroenterology, Sapporo Medical Center NTT EC, Sapporo, Japan. 14. Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan.
Abstract
BACKGROUND: Transabdominal ultrasonography (US) has been reported to be a useful tool for evaluating ulcerative colitis (UC) although with less well-established data than for Crohn's disease. This prospective multicenter study aimed to establish the usefulness of US compared with colonoscopy (CS) for assessing disease extent and activity of UC. METHODS: Altogether, 173 patients with UC were prospectively enrolled, among whom 156 were eligible for this study. All patients underwent US and CS within 2 days at five facilities. We divided the colon into six segments and examined each segment and the rectum using US and CS. US severity was graded 1-4 regarding bowel wall thickness, stratification, and ulceration. CS severity was also graded 1-4 according to Matts' endoscopic classification. Concordance between US and CS grades for all colonic segments was analyzed using kappa statistics. US and CS findings were also compared with the clinical disease activity index (CAI) and histological grade using Spearman's correlation coefficient. RESULTS: There was moderate concordance between US and CS grades in all colonic segments (weighted κ = 0.55, p < 0.001). Concordance was rated moderate for each colonic segment but only slight for the rectum. The US grade was significantly correlated with the CAI score (r = 0.40, p < 0.001) and histological grade (r = 0.35, p < 0.001). CONCLUSIONS: This prospective multicenter study showed moderate concordance between US and CS for assessing the disease activity of UC. Hence, US may be used more generally for evaluating UC in daily clinical practice.
BACKGROUND: Transabdominal ultrasonography (US) has been reported to be a useful tool for evaluating ulcerative colitis (UC) although with less well-established data than for Crohn's disease. This prospective multicenter study aimed to establish the usefulness of US compared with colonoscopy (CS) for assessing disease extent and activity of UC. METHODS: Altogether, 173 patients with UC were prospectively enrolled, among whom 156 were eligible for this study. All patients underwent US and CS within 2 days at five facilities. We divided the colon into six segments and examined each segment and the rectum using US and CS. US severity was graded 1-4 regarding bowel wall thickness, stratification, and ulceration. CS severity was also graded 1-4 according to Matts' endoscopic classification. Concordance between US and CS grades for all colonic segments was analyzed using kappa statistics. US and CS findings were also compared with the clinical disease activity index (CAI) and histological grade using Spearman's correlation coefficient. RESULTS: There was moderate concordance between US and CS grades in all colonic segments (weighted κ = 0.55, p < 0.001). Concordance was rated moderate for each colonic segment but only slight for the rectum. The US grade was significantly correlated with the CAI score (r = 0.40, p < 0.001) and histological grade (r = 0.35, p < 0.001). CONCLUSIONS: This prospective multicenter study showed moderate concordance between US and CS for assessing the disease activity of UC. Hence, US may be used more generally for evaluating UC in daily clinical practice.
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