Bowel Ultrasonography in Inflammatory Bowel Disease

Abstract

Background: The diagnosis of inflammatory bowel disease (IBD) is based on a combination of endoscopic, clinical and biochemical investigations as well as cross-sectional imaging. The applications of cross-sectional imaging in IBD are manifold. Ultrasonography has emerged as an important imaging modality in the diagnosis of Crohn's disease (CD) as well as for monitoring disease progression and in the therapeutic response to CD and ulcerative colitis (UC). Key Messages: Ultrasonography is non-invasive, radiation free, cheap, easy to use and well tolerated and accepted by patients. Bowel ultrasonography can be used for the primary diagnosis of CD as it has a similar sensitivity and specificity like that of MRI and CT, particularly in the case of CD. Ultrasonography can also be used to monitor treatment response to therapy and to detect disease recurrence of CD as well as UC. In CD, ultrasonography can also be used to detect complications such as strictures as well as extramural complications, including abscesses and fistulas. Contrast-enhanced ultrasonography is a useful tool that might be helpful to detect certain indications in CD, in particular the differentiation between abscesses and inflammation. Conclusion: A variety of advantages of bowel ultrasonography over other imaging modalities suggest the more frequent use of this method to manage IBD patients in daily practice. Bowel ultrasonography should be a standard tool in IBD centers.

Comparative study between bowel ultrasound and magnetic resonance enterography among Egyptian inflammatory bowel disease patients

“…Our study agreed with different trials in which it was shown that diagnosis of IBD and assessment of its activity cannot be dependent on clinical evaluation alone but should by combined with other investigations such as biomarkers, endoscopy, and imaging techniques such as bowel ultrasound and MRE[ 25 , 30 ].…”

“…This indicates that there is no clear gold standard imaging technique for IBD diagnosis including MRE or bowel ultrasound which could be used besides clinical history, biomarkers, endoscopy for diagnosis of IBD as agreed with previous studies[ 25 , 30 , 36 ].…”

The use of ultrasound in inflammatory bowel disease

“…The diagnosis of IBD is confirmed by clinical evaluation and by a combination of other investigative modalities, including history, biomarkers, endoscopy, and cross-sectional imaging such as IUS. As a current methodology with a high negative predictive value, IUS is accepted as a first-line tool in the primary diagnosis workup of adults and children with suspected small bowel inflammation [ 30 , 43 - 46 ]. If the appropriate expertise is available, IUS could also be used as a primary diagnostic modality in adult CD patients and MRI could be reserved for patients with unclear findings or symptoms.…”

Abdominal ultrasonography with color Doppler analysis in the assessment of ileal Crohn’s disease: comparison with magnetic resonance enterography

“…Although Doppler sonography does not constitute a routine first-line tool for the initial diagnosis of CD, it has been proposed as a potential adjunct method for the follow-up of patients [45]. Nevertheless, in this study, results from imaging methods, MRE and USCD, showed no significant agreement with the clinical CD activity, and with the currently used biomarkers, serum CRP and fecal calprotectin.…”