الفهرس 
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Abstract
IBD are chronic, progressive, and disabling conditions, characterized by episodes of remission and relapses in various parts of the gastrointestinal tract and long-term complications (Lim et al., 2023).
Colonoscopy is considered as the gold standard in establishing the diagnosis of IBD and determining its disease activity. However, it is an invasive procedure with the risk of bleeding and perforation, and a possible unpleasant experience due to the need of bowel preparation (Kishi et al., 2022).
IUS is a real-time imaging tool that can be used at the point-of-care to assess disease activity in both Crohn’s and ulcerative colitis patients. IUS has the advantage of being non invasive, inexpensive, widely available, and does not involve ionizing radiation. IUS promotes quick and impactful treatment decisions that can modify disease progression and enhance patient compliance (Dolinger and Kayal, 2023).
IBD activity can be assessed through Color Doppler Imaging of the bowel wall. Increased vascularization in the penetrating vessels in the bowel wall is a sign of active inflammation. Currently, the simple Limberg score can be employed for a semi quantitative characterization of the bowel wall vascularization which is divided into categories (Lin et al., 2023)
This prospective study aim to assess the usefulness of IUS parameters in the detection of the disease activity in inflammatory bowel diseases patients. We also investigated the relation between intestinal US parameters and multiple scores which reflect the inflammatory diseases activity in addition to the endoscopic activity including clinical activity scores and fecal calprotectin.
Roc curve analysis of our study revealed the ability of the BWT to differentiate between mild and moderate disease activity in IBD patients at a cut-off value of (3.7 mm), with sensitivity of 90.91% and specificity of 100.0%, with area under curve (AUC) of 0.909 using the endoscopic activity as a gold standard reference.
Our study revealed higher mean values of the bowel wall thickness measurements compared to disease activity degree assessed by SES-CD activity in CD patients (F = 16.380, P= 0.002).
Similarly, our study revealed higher vascular Doppler grading by Limberg score compared to degrees of disease activity assessed by SES-CD activity in CD patients (χ2 = 22.000, p = 0.009).
Considering patients with UC, our study revealed a significantly higher mean values of the BWT compared to the grading of disease activity by endoscopic Mayo score in UC patients (F = 13.368, p = 0.001).
Similarly, our study revealed a significantly higher Doppler signal grades by Limberg scores, associated with increased severity grading by Endoscopic Mayo score in UC patients (χ2 = 21.840, p=0.005).
Our study demonstrated a statistically significant positive strong correlation between the FC level measurements and BWT among both UC and CD patients (r=0.708, P = 0.000) and (r=0.736, p = 0.003) respectively.
Also, the current study showed a significantly higher values of BWT associated with increased disease activity calculated by the HBI in CD patients (F= 9.450, p = 0.004) and the clinical partial Mayo score in UC patients (F = 7.875, p = 0.001).
Lastly, our study showed a statistically significant correlation between the Doppler grading and clinical activity score in UC patients (χ2 = 23.697, p = 0.022), however no correlation found between the Doppler grading and clinical activity index in CD patients.
In conclusion, the results of our study suggest that IUS could serve as noninvasive tool in detecting IBD activity namely the BWT and Color Doppler signal. Intestinal US could be one of the promising methods, which can be employed as an adjunct for detection of disease activity and monitoring of IBD patients. Further studies with larger sample size are needed to emphasize the role of the IUS in assessment and follow of diseases activity in IBD patients.