The severity of ulcerative colitis activity can be evaluated using ultrasound of the colon. This correlates well with disease actvity seen on endoscopy.
Patient selection: ultrasonography of the entire length of the colon
Segments for colon:
(1) cecum and ascending colon
(2) right-sided transverse colon
(3) left-sided transverse colon
(4) descending colon
(5) sigmoid colon
(6) rectum
Ultrasound Findings
Grade
normal (< 4 mm)
1
thickened mucosa and submucosa without hypoechoic change of the submucosa
2
bowel wall thickening with loss of stratification
3
bowel wall thickening with loss of stratification and irregular mucosa OR hyper-echogenic areas in the mucosa suggesting ulceration
4
difficult to observe
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