Abstract
Technological improvements and growing sonographers’ expertise boost the role of intestinal
ultrasound (IUS) in assessing patients with inflammatory bowel diseases (IBD). Non-invasiveness,
low cost and good reproducibility make IUS attractive.
Leveraging on the Authors’ long-term field experience, this review focuses on the
IUS role in IBD patients’ clinical management.
For detecting IBD, particularly Crohn’s disease, the IUS parameters — above all the
evidence of a thickened bowel wall (BWT) — show very good diagnostic accuracy similar
to that of MRI or CT scan.
The standard IUS parameters are not accurate enough to detect inflammatory activity,
but intravenous contrast-enhanced US (CEUS) is highly accurate in ruling active inflammation
out. However, its routinely use remains limited in clinical practice and its parameters
need standardization.
IUS is accurate in detecting IBD main complications: in particular, fistulae and abscesses.
As to stenosis the recent introduction of IUS-based elastographic techniques allows
to differentiate prevalently inflammatory from highly fibrotic strictures.
IUS proves valid also for monitoring IBD patients. In particular, the evidence of
transmural healing, defined as BWT normalization, has got an important prognostic
meaning, as associated with better long-term clinical outcomes. Post-surgery CD recurrence
can be suggested by early IUS assessment.
Keywords
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Article info
Publication history
Published online: November 12, 2019
Accepted:
October 8,
2019
Received:
June 6,
2019
Identification
Copyright
© 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Gastrointestinal ultrasound in inflammatory bowel disease: Seeing beyond limitsDigestive and Liver DiseaseVol. 52Issue 1
- PreviewWhen ultrasonography was first introduced in clinical practice, its use was characterized by three dogmas: air was an insuperable limitation; the bowel was impenetrable; and the results were operator dependent. Indications that air was useful in the ultrasonographic evaluation of the gastrointestinal tract came in the early 1980s [1], but the first dogma was only rebutted years later when air was shown to not be an obstacle to ultrasonographic imaging of the lungs [2]. The second dogma was first challenged by a 1979 case series [3] in Crohn’s disease.
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