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Original Articles
- Transabdominal intestinal ultrasound parameters as intermediate treatment targets in a treat-to-target strategy for moderate-to-severe ulcerative colitis
- Longxi Yun, Zhaojue Wang, Qingli Zhu, Yalong Zhu, Hui Xu, Bei Tan, Wenbo Li, Yue Li
- Received November 12, 2025 Accepted January 25, 2026 Published online May 19, 2026
- DOI: https://doi.org/10.5217/ir.2025.00286 [Epub ahead of print]
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Abstract
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Supplementary Material
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ePub - Background/Aims
This study aimed to investigate the prognostic value of early post-induction intestinal ultrasound (IUS) f indings in predicting long-term clinical outcomes among patients with moderate-to-severe ulcerative colitis (UC).
Methods
This retrospective, single-center study consecutively enrolled patients with moderate-to-severe, left-sided or extensive UC. Clinical endpoints were assessed at the end of follow-up or 1 year after induction therapy (for patients with at least 1 year of follow-up) and categorized as clinical remission (Short Clinical Colitis Activity Index [SCCAI] ≤2) or non-remission (SCCAI >2). Patients who experienced a negative disease course before the evaluation point were classified as clinical non-remission.
Results
A total of 56 patients were included. The bowel wall thickness (BWT; 5.1±1.7 mm vs. 6.0±1.4 mm; P=0.032) and Milan ultrasound criteria (MUC; 8.3±3.2 vs. 9.9±2.2; P=0.029) evaluated at early follow-up IUS were lower for patients reaching longterm clinical remission. Patients with BWT <5 mm on early follow-up IUS (83% vs. 45%; P=0.006) or MUC <6.2 (100% vs. 45%; P<0.001) had a significantly higher rate of long-term clinical remission. Kaplan-Meier analysis revealed a lower cumulative probability of a negative disease course in patients with BWT <5 mm (P=0.025) or MUC <6.2 (P=0.025). Cox regression analysis identified BWT ≥5 mm as an independent predictor of a negative disease course.
Conclusions
BWT <5 mm and MUC <6.2 may serve as intermediate targets for IUS-guided “treat-to-target” strategy, offering a practical approach to improve longterm clinical remission in patients with moderate-to-severe UC.
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- Integrating perspectives on transabdominal intestinal ultrasound in inflammatory bowel disease management: a nationwide cross-sectional survey of physicians and patients in China
- Longxi Yun, Zhaojue Wang, Yujun Chen, Ning Chen, Yan Chen, Xiaoqi Zhang, Xiaoyan Xie, Ren Mao, Yue Li, Qingli Zhu, Minhu Chen, China IUS Group
- Received May 8, 2025 Accepted August 21, 2025 Published online January 2, 2026
- DOI: https://doi.org/10.5217/ir.2025.00074 [Epub ahead of print]
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background/Aims
The awareness, accessibility, and utilization of transabdominal intestinal ultrasound (IUS) in inflammatory bowel disease (IBD) management from both physicians’ and patients’ perspectives remains unclear in China. This nationwide cross-sectional survey aimed to gauge the current utilization of IUS, physician and patient perceptions and knowledge gap in IBD management across China.
Methods
A structured questionnaire, developed by the China IUS Group, was distributed to 612 physicians (69.8% of gastroenterologists, 28.0% of radiologists) from 38 tertiary hospitals and 1,154 IBD patients. Results: A total of 91.7% of physicians expressed an intention to incorporate IUS into future clinical practice. However, while 69.3% of physicians reported IUS availability at their institutions, its utilization varied widely. Only 16.5% of physicians applied IUS to more than 75% of their IBD patients. Additionally, 27.1% of physicians reported receiving IUS training. Radiologists were more likely than gastroenterologists to consider IUS as a sensitive tool for evaluating treatment efficacy (48.3% vs. 19.4%, P< 0.001), intestinal wall fibrosis (33.7% vs. 27.4%, P< 0.001), intestinal fistula (27.9% vs. 11.2%, P< 0.001), abdominal abscesses (49.4% vs. 28.6%, P< 0.001), and disease severity (30.2% vs. 11.0%, P< 0.001). Patients expressed high satisfaction with IUS (76.1%), yet 39.2% had safety concerns.
Conclusions
Despite growing recognition of IUS in China, its wide utilization in IBD management requires further promotion. The notable disparity between gastroenterologists and radiologists regarding IUS underscores the need for targeted, specialty-specific training. Strengthening patient education efforts is essential to further enhance patient acceptance of IUS.
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