Endoscopy 2011; 43 - A146
DOI: 10.1055/s-0031-1292217

The value of Endoscopic ultrasonography in the assessment of ulcerative colitis

Guo Wen 1, Liu Si-de 1, Bai Lan 1, Cheng Tian-ming 1, Chen Cun-long 1, Zhi Fa-chao 1, Jiang Bo 1
  • 1The Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangdong provincial Key laboratory of Gastroenterology, Guangzhou 510515, China

Objective: To evaluate the value of endoscopic ultrasonography (EUS) in the diagnosis of ulcerative colitis (UC).

Methods: EUS was carried out in 58 patients with active ulcerative colitis. Wall features and percolorectal lymph nodes were documented systematically. The correlation between Baron' endoscopic grades in ulcerative colitis and colorectal wall structure were evaluated ulteriorly.

Results: The total wall thickness was increased, with (6.43±0.42)mm on average. The thickening of the mucosal (M), submucal (SM), muscularis propria (MP) and serosa (S) or adventitia (A) layers of the colonic wall were observed in patients with ulcerative colitis for: M 86.2% (50/58), SM 79.3% (46/58), MP 62.1% (36/58), S 70.7% (41/58), respectively. Among them, 81.8% MP layer was thickening in Baron' grades 4, significantly higher than Baron' grades 2 (0%) and 3 (33.3%) cases (p<0.05). The layers of the colorectal wall were clearly seen in most of these patients. In patients with acute UC the mucosa appeared abnormal in 86.2% (50/58) of cases, 8 cases (13.8%) of a three-layer structure and 30 cases (51.7%) of a four-layer structure. The former was seen all in the Baron' grades 4 cases, the latter was observed in 27 patients (65.9%) of Baron' grades 4, significantly higher than Baron' grades 2 (0%) and 3 (18.2%) cases (p<0.05). Submucosa and muscularis propria layer were also always preserved. Thickening and increased echogenicity of the fifth layer was seen in 41 (70.7%) patients. 6 cases (10.3%) of enlarged vessels and 31 cases (53.4%) of polypus were observed. The existence of percolorectal pathological lymph nodes was found in 34 patients (58.6%), no significantly different between the patient subgroups of Baron' grades.

Conclusions: EUS can show the depth of inflammation in UC, and the EUS images were correlation with the severity of colonoscopic changes. EUS is a reliable and useful diagnostic tool to assess the severity and anticipate the prognosis of active ulcerative colitis, and beneficial to choose the therapic project.