Abstract
Background
Mucosal healing, the result of endoscopic remission, is associated with prolonged
clinical remission and delayed deterioration of Crohn's disease, which is significant
and accompanied by reduced hospitalizations and surgeries. Currently, the relationship
between ultrasonic parameters and mucosal healing remains controversial. To establish
an ultrasonic regression model to evaluate mucosal healing, we conducted this preliminary
study using multiple parameters from B-mode ultrasonography, colour Doppler flow imaging
and shear wave elastography systematically.
Methods
This study consisted of two single-centre investigations based on development and
validation populations who received endoscopies (as the gold standard) and ultrasound.
The involved bowel segments were divided into mucosal healing (MH) and nonmucosal
healing (NMH) groups according to endoscopic results. Eight ultrasonic parameters
were observed, including bowel wall thickness (BWT), mesenteric fat thickness (MFT),
median modulus of elasticity (Emean), average shear wave velocity (SWV), Limberg scoring
(LG), bowel wall stratification (BWS), ascites (AS) and lymph node enlargement (LN).
We developed an ultrasonic regression model in the development phase to evaluate segmental
mucosal healing and undertook prospective validation of this model.
Results
A total of 124 patients with 380 involved bowel segments from the development and
validation cohorts were evaluated. Eight ultrasonic parameters were significantly
different between the two groups (P<0.05) in the development phase. Four significant parameters with better AUC performance
were selected to establish an ultrasonic regression model to predict mucosal healing.
The AUCs of this ultrasonic model were 0.975 and 0.942 in the development and validation
cohorts, respectively.
Conclusion
The multimodal ultrasonic model has the potential to evaluate segmental mucosal healing
in Crohn's disease.
Keywords
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Article info
Publication history
Published online: January 03, 2022
Accepted:
December 8,
2021
Received:
August 30,
2021
Footnotes
Supported by the National Nature Science Foundation of China (81,101,061) and the Science and Technology Planning Project of Sichuan Province of China (2021YJ0243).
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
