# Clinical value of multimodal ultrasound in evaluating intestinal stiffness and fibrosis in active Crohn’s disease

## TL;DR

This study shows that a type of ultrasound called VTIQ can accurately detect intestinal stiffness in Crohn’s disease, offering a non-invasive alternative to traditional methods.

## Contribution

The study introduces VTIQ as a more accurate method for assessing intestinal stiffness in Crohn’s disease compared to conventional ultrasound.

## Key findings

- Shear wave velocity was the most accurate predictor of intestinal stenosis with an AUC of 0.838.
- Combining ultrasound indices improved diagnostic accuracy with an AUC of 0.878.
- The ultrasound-based approach showed 100% specificity and 71% sensitivity for stenosis detection.

## Abstract

It was hypothesized that virtual touch tissue imaging and quantification (VTIQ) is more accurate in quantifying intestinal stiffness compared to conventional B-mode ultrasound for detecting Crohn’s disease (CD) stenosis. We aimed to explore the diagnostic value of multimodal ultrasound in intestinal stenosis of CD.

A retrospective analysis of CD patients (May 2020 to October 2024) was conducted. Risk factors associated with intestinal stenosis in CD were identified using univariate and multivariate logistic regression analysis. The area under the curve (AUC) of the receiver operating characteristic (ROC) of combined indices was compared with individual indices to assess their predictive ability for intestinal stenosis in CD.

Sixty-three patients were included. Univariate and multivariate logistic regression analysis identified shear wave velocity (OR = 3.943, p = 0.008), Young’s modulus value (OR = 1.079, p = 0.046), and intestinal bowel ultrasound stenosis assessment score (IBUS-SAS; OR = 1.033, p = 0.015) as significant risk factors. The AUC for IBUS-SAS was 0.671, for shear wave velocity was 0.838, and for Young’s modulus value was 0.788. The combined model yielded an AUC of 0.878. Compared to the gold standard (Simplified Endoscopy for Crohn’s Disease, SES-CD), the ultrasound-based approach showed 100% specificity and 71% sensitivity for stenosis detection.

IBUS-SAS, shear wave velocity, and Young’s modulus were independent risk factors for CD intestinal stenosis, with shear wave velocity being the most accurate (AUC = 0.838), supporting our hypothesis. These findings warrant validation in large, high-quality studies.

This study examines the potential of VTIQ ultrasound to assess intestinal stiffness in CD, offering a non-invasive, radiation-free approach that may enhance diagnostic capabilities and contribute to clinical radiology practice.

VTIQ non-invasively assesses intestinal stiffness in CD.Shear wave velocity, Young’s modulus, and IBUS-SAS predict stenosis.Integrated indices improve diagnostic accuracy.VTIQ shows promise for safe, non-invasive diagnosis.Requires large-scale, multicenter studies for confirmation.

VTIQ non-invasively assesses intestinal stiffness in CD.

Shear wave velocity, Young’s modulus, and IBUS-SAS predict stenosis.

Integrated indices improve diagnostic accuracy.

VTIQ shows promise for safe, non-invasive diagnosis.

Requires large-scale, multicenter studies for confirmation.