ArticleJournal of Crohn's & colitis2025
Submucosal hyper-echogenicity on intestinal ultrasound is associated with fat deposition and predicts treatment non-response in patients with ulcerative colitis.
Article in Journal of Crohn's & colitis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Intestinal Ultrasound-Guided Precision Medicine in Inflammatory Bowel Diseases: A Narrative Review.Journal of personalized medicine · 2026Review
- Myokine-mediated mechanisms of immune checkpoint inhibitors-associated colorectal injury and repair in rectal cancer.Frontiers in immunology · 2026Review
- Transabdominal Intestinal Ultrasonography in Monitoring and Predicting Outcomes in Ulcerative Colitis-A Systematic Review.Journal of clinical medicine · 2025Review
- Kinetics of intestinal ultrasound and shear-wave elastography to assess early response in ulcerative colitis patients treated with filgotinib.Journal of Crohn's & colitis · 2025Observational
- Transmural healing in ulcerative colitis patients improves long-term outcomes compared to endoscopic healing alone.Journal of Crohn's & colitis · 2025Article
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Authors and funding
8 authors.
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Abstract
BACKGROUND AND
aimsThe submucosa is the most responsive bowel wall layer on intestinal ultrasound (IUS) when assessing treatment response in ulcerative colitis (UC). Submucosal thickening with hyper-echogenicity is observed. This study aimed to quantify echogenicity and understand transmural changes in UC.
methodsIn total, 118 patients were studied in two cohorts. Cohort 1 included colectomy patients: 19 UC patients and 52 controls without inflammatory bowel disease. Cohort 2 included 47 UC patients in a prospective cohort starting anti-inflammatory treatment. In Cohort 1, submucosal inflammation, and fat and collagen deposition were scored by two pathologists using a semi-quantitative scale (0-3). For UC patients in Cohort 1, histopathology and IUS of the sigmoid were location matched. Relative submucosal echogenicity (RSE) was assessed, quantified in grayscale values. In Cohort 2, baseline sigmoid RSE was compared between endoscopic responders (≥1 point decrease in endoscopic Mayo score after 8-26 weeks) and non-responders.
resultsIn all colectomized UC patients with preserved wall layer stratification (n = 12, 63%), submucosal fat (score ≥1) was present; in those with loss of stratification (n = 7, 37%), fat was absent (score = 0). RSE was higher when fat was present [95.5 (IQR 86.5-116.9) vs 8.1 (IQR 5.8-23.0) grayscale values, P < .001], with no significant differences for inflammation and collagen. In Cohort 2, RSE was higher in non-responders (n = 17) compared to responders (137.1 ± 50.9 vs 88.3 ± 49.6 grayscale values, P = .003). An RSE of >108 grayscale values predicted non-response [OR: 0.07 (95% CI: 0.01-0.44), P = .004].
conclusionSubmucosal hyper-echogenicity on IUS indicates fat deposition and predicts non-response in UC.
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