Background: Intestinal ultrasound (IUS) has become an essential, non-invasive tool for evaluating gastrointestinal involvement in inflammatory bowel disease (IBD), particularly ulcerative colitis (UC). With advancements in ultrasound technology, its diagnostic accuracy has significantly improved. This study aimed to evaluate UC activity by means of a new ultrasound-based activity index, with endoscopic results serving as the gold standard. Methods: Fifty patients with confirmed UC were enrolled from the Internal Medicine Department at Benha University Hospital in Egypt. They were categorized into two groups: 25 patients in remission (inactive UC) and 25 with active diseases. All participants underwent clinical evaluation, colonoscopy, laboratory investigations, and intestinal ultrasound examination. Results: Patients with active UC had significantly higher levels of bowel wall thickness (BWT) and the UC intestinal ultrasound severity index (UC-IUS) when contrasted with those in remission (P < 0.001). Active cases also showed more distortions in the stratification of the wall (P = 0.015) and aberrant haustrations (P = 0.002). The severity of the disease was significantly predicted by BWT. A BWT > 3 mm was associated with an AUC of 0.739 (P = 0.001), sensitivity of 83.33%, and negative predictive value (NPV) of 92% for severe UC. The AUC for moderate UC was 0.822 (P < 0.001), with a sensitivity of 90.91% and a 95.5 percent NPV, when the cutoff was >2.5 mm. Conclusions: For the evaluation of disease activity in UC, IUS is a dependable and non-invasive technique. BWT demonstrates strong potential as a marker for disease severity and could guide treatment decisions effectively. |
