Open Access Research article

Images of colonic real-time tissue sonoelastography correlate with those of colonoscopy and may predict response to therapy in patients with ulcerative colitis

Daisuke Ishikawa1, Takafumi Ando1*, Osamu Watanabe1, Kazuhiro Ishiguro1, Osamu Maeda1, Nobuyuki Miyake1, Masanao Nakamura1, Ryoji Miyahara2, Naoki Ohmiya1, Yoshiki Hirooka2, Emad M El-Omar3 and Hidemi Goto12

Author Affiliations

1 Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan

2 Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan

3 Department of Medicine and Therapeutics, University of Aberdeen, Aberdeen, UK

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BMC Gastroenterology 2011, 11:29  doi:10.1186/1471-230X-11-29

Published: 31 March 2011



Real-time tissue sonoelastography (EG) is a new non-invasive technique that visualizes differences in tissue strain. We evaluated the usefulness of EG in patients with ulcerative colitis (UC) by investigating the association between EG and colonoscopic findings and disease activity.


Thirty-seven UC patients undergoing EG and colonoscopy were invited to enroll. EG findings were classified as normal, homogeneous, random, or hard, and colonoscopic findings as normal, mucosal edema and erosion, punched-out ulcer, and extensive mucosal abrasion. Clinical findings were evaluated using clinical activity index (CAI) scores for each patient at colonoscopy.


On EG, 10 cases were classified as normal, 11 as homogeneous, 6 as random, and 10 as hard. EG findings showed a significant correlation those of colonoscopy (p < 0.001). Seven of 10 (70%) normal-type patients were in the remission phase, while all 6 random-type patients were in the active phase. Among active-phase patients, 4 of 7 (57%) homogeneous-type patients responded to steroid or leukocytapheresis therapy, while 3 of 6 (50%) random-type patients required treatment with cyclosporine. Three of 10 (30%) hard-type patients required colectomy.


In this small series, EG findings reflected colonoscopic findings and correlated with disease activity among patients with UC.