Background Ulcerative colitis (UC) is a chronic remittent gastrointestinal disease affecting the colon. Ileocolonoscopy and histopathology are the mainstay tools for diagnosis and monitoring response to treatment which are invasive. There is unmet need for non-invasive tools for diagnosis and monitoring UC patients.
Objectives:  Bowel Ultrasound (BUS) and elastography are a promising non-invasive tool for this issue. We studied the validity of BUS in UC diagnosis and prediction of response to treatment.
Patients and methods 48 participants were included, classified into 18 patients with active UC, 15 UC patients in remission and another 15 participants as a control group. BWT, WLS, CDS, pericolic lymph nodes presence and pericolic fat echogenicity had revealed a clinical significance in UC diagnosis and prediction of response to treatment.
Results: BWT had a perfect agreement at UC diagnosis and prediction of response to treatment at a cut off point 0.3 cm with 94.0% accuracy, 94.4% sensitivity, 93.3% specificity, 94.4% PPV and 93.3% NPV with P value <0.001. bowel shear wave elastography showed a clinical significance in UC diagnosis. Using shear wave elastography E1 comparing active UC patients vs. patients in remission with cut off value 1 kPa had 0.750 AUC, 95% CI with 88.9% sensitivity, 53.3% specificity, 69.6% PPV and 80.0% NPV with P value 0.004, but SR didn't show any significance either in diagnosis or monitoring UC patients.
Conclusion: BUS can be used in diagnosis and monitoring UC patients instead of or beside ileocolonoscopy and histopathology to decrease the burden of the disease. Further research is needed to study shear wave elastography to get its benefit and to use in scoring systems for diagnosis and disease monitoring.