Table 4.

Histological scores adopted in included studies.

Reference, first author	Inflammation score	Fibrosis score	Main achievements
Dillman JR19	0 = o inflammation 1 = ow level of inflammation with scattered infiltrating mononuclear cells 2 = oderate inflammation with multiple foci 3 = igh level of inflammation with increased vascular density and marked wall thickening 4 = aximal severity of inflammation with transmural leukocyte infiltration and loss of goblet cellsa	0 = o architectural distortion, no abnormal Masson trichrome staining 1 = o architectural distortion, mild abnormal Masson trichrome staining in mucosa/submucosa 2 = ubstantial abnormal mucosal/submucosal Masson trichrome staining with modest distortion of architecture but without obscuration of the mucosal/submucosal border 3 = ransmural fibrosis with abnormal Masson trichrome staining in all histological layers, transmural architectural distortion	Statistically significant difference of SWE throughout the classes of fibrosis [low vs high fibrosis AUC max = 0.91]
Baumgart DC20	1.presence of intraepithelial neutrophils [0 = none, 1 = few, 2 = excessive] 2.goblet cell reduction in crypts with surrounding neutrophils [0 = none, 1 = little, 2 = excessive] 3.excess of neutrophils in lamina propria [0 = none, 1 = few, 2 = excessive] 4.presence of crypt atrophy [0 = absent, 1 = present] 5.presence of fibrosis [0 = absent, 1 = present]b	0 = o increased collagen deposition 1 = ncreased collagen deposition in submucosa 2 = ncreased collagen deposition in submucosa and mucosa 3 = ncreased collagen deposition in muscularis mucosa, submucosa, and mucosa, as well as thickening and disorganiation of the muscularis mucosa 4 = ncreased collagen deposition in muscularis propria, muscularis mucosa, submucosa, and mucosa 5 = increased collagen throughout all layers, including serosae	Higher collagen content in affected versus unaffected segments associated with RTE-assessed strain [p <0..001]
Fraquelli M21	acute inflammatory score, and chronic inflammatory score ‡	Mild/moderate versus severec	Strain ratio was significantly correlated with the bowel fibrosis [AUC for severe fibrosis = 0.917]. Bowel fibrosis was the only independent determinant of the strain ratio at multivariate analysis
Lu C22	1.acute inflammatory score [ulceration, cryptitis, crypt abscess, lamina propria neutrophilic infiltration] 2.chronic inflammatory score [lamina propria lymphoplasmacytic cellularity, lamina propria eosinophilic infiltration, crypt architecture alteration]	0 = one 1= <33% 2= >33% and <66% 3= 66%	Correlation observed between SWE and muscular hypertrophy No correlation between SWE and fibrosis score
Serra C23	0 = o polymorphonuclear or mononuclear leukocytes infiltrates 1 = Mild] cryptitis, leukocytes infiltrates limited to mucosa 2 = Moderate] cryptitis, crypt abscess, and leukocytes infiltrates until the submucosa 3 = [Severe] transmural inflammation with leukocytes infiltrates in all the layersc	0 = one or normal fibrosis 1 = inimal fibrosis limited to submucosa 2 = Submucosaland muscular layer fibrosis <30% 3 = ubmucosal and muscular layer fibrosis between 30% and 60%, with preserved layers 4 = Massive transmural fibrosis >60%, effacement of normal layersc	No correlation between SE and fibrosis score
Chen YJ24	0 = o inflammation or distortion 1 = amina propria inflammation only 2 = ubmucosal foci of inflammation and/or foci of transmural inflammation 3 = ignificant, dissecting, confluent transmural inflammation	0 = o fibrosis 1 = inimal fibrosis in submucosa or subserosa 2 = ncreased submucosal fibrosis, septa into muscularis propria and/or septa through muscularis propria, increase in sub-serosal collagen 3 = ignificant transmural scar, marked sub-serosal collagen	SWE was significantly different throughout the classes of fibrosis [mild/moderate vs severe fibrosis AUC = 0.822; sensitivity = 69.6%; specificity = 91.7%]. No difference in SWE observed with respect to inflammation classes. Combined SWE + US showed a moderate agreement with the classes of strictures
Quaia E25	1.mucosal ulceration [grade 0–3] 2.edema [grade 0–3] 3.quantity [grade 0–3] of neutrophilic infiltration 4.depth [grade 0–4] of neutrophilic infiltrationc	Sections were scored as positive for fibrosis if at least moderate fibrosis was observed which involved the submucosa or deeper layersd	SE was able to differentiate between fibrosis and inflammation with a maximal AUC of 0.885

RTE; real-time elastography; SE, strain elastography; AUC, area under the curve; SWE, shear wave elastography.

According to Likert-like scales.

According to Bataille F, Klebl F, Rümmele P, et al. Histopathological parameters as predictors for the course of Crohn’s disease. Virchows Arch 2003;443:501–7.

According to Chiorean MV, Sandrasegaran K, Saxena R, et al. Correlation of CT enteroclysis with surgical pathology in Crohn’s disease. Am J Gastroenterol 2007;102:2541–50 and/or Borley NR, Mortensen NJ, Jewell DP, et al. The relationship between inflammatory and serosal connective tissue changes in ileal Crohn’s disease: evidence for a possible causative link. J Pathol 2000;190:196–202.

According to Gupta RB, Harpaz N, Itzkowitz S, et al. Histologic inflammation is a risk factor for progression to colorectal neoplasia in ulcerative colitis: a cohort study. Gastroenterology 2007;133:1099–105.

According to Theiss AL, Fuller CR, Simmons JG, Liu B, Sartor RB, Lund PK. Growth hormone reduces the severity of fibrosis associated with chronic intestinal inflammation. Gastroenterology 2005;129:204–19.