Shear Wave and Strain Elastography in Crohn’s Disease—A Systematic Review

Abstract

One modern imaging technique used in the diagnosis of Crohn’s disease (CD) is sonoelastrography of the intestine. Guidelines regarding the use of bowel sonoelastography in CD have still not been specified. The aim of our research was to conduct a systematic review of the use of sonoelastography in the diagnosis, assessment, and monitoring of strictures in the course of CD. A systematic review was conducted according to the PRISMA guidelines statement. The following databases were searched in January 2021: MEDINE via PubMed, Embase and Scopus. The search utilised the following MeSH tags: ‘Ultrasound Shear Wave’, ‘Elastography’, ‘elastogram’, ‘elastographies’ AND ‘Crohn disease’. The inclusion criteria were as follows: from 2010 or later, articles with abstracts, articles in English, human-based studies and original articles. Articles were assessed independently by two reviewers. Out of 181 articles, only 15 met the criteria and were included in the review. Due to a small number of studies and significant methodological differences, the feasibility of using sonoelastography for Crohn’s disease must be proven through further research and analysis. In the future, standardised assessment criteria and cut-off points should be established for both strain elastography (SE) and shear wave elastography (SWE).

The knowledge and skills needed to perform intestinal ultrasound for inflammatory bowel diseases—an international Delphi consensus survey

“…Although the Delphi panel had suggested knowledge about elastography and the ability to perform elastography in the first round, they found very limited support in the final Delphi round. In recent studies, elastography has shown promising results, but no standardisation or consensus exists on its implementation or clinical use 17,18 . This is likely the reason why the Delphi panel chose not to recommend any elastography knowledge or skills.…”

“…In recent studies, elastography has shown promising results, but no standardisation or consensus exists on its implementation or clinical use. 17,18 This is likely the reason why the Delphi panel chose not to recommend any elastography knowledge or skills. Statements regarding the ability to perform and interpret small intestine contrast-enhanced ultrasonography (SICUS) surprisingly found very limited support.…”

Pancreatic shear wave elastography in children with type 1 diabetes: relation to diabetes duration, glycemic indices, fasting C-peptide and diabetic complications

“…Later, it was used to assess other tissues including the breast and thyroid gland [ 11 , 12 ]. SWE is useful in differentiating tissue inflammation from fibrosis, owing to the difference in tissue stiffness, being low in inflammation and high in fibrosis [ 13 – 15 ].…”

Quantitative Assessment of Breast-Tumor Stiffness Using Shear-Wave Elastography Histograms

“…Shear-wave elastography (SWE™) is a sonographic method for the detection of tissue stiffness by measuring the attenuation of a shear wave delivered perpendicular to the tissue [ 3 , 4 , 5 , 6 ] ( Figure 1 a). Several SWE tissue applications [ 4 , 7 ] in the muscle–skeletal system [ 8 ] and liver [ 9 , 10 , 11 ], as well as innovative applications in vessel imaging [ 12 ], the small intestine in Crohn’s disease [ 13 ], thyroid nodules [ 14 , 15 ], the prostate [ 16 ] and breast ultrasound [ 17 ], ought to improve the diagnostic yield of B-mode. SWE implements a technology of two crossing ultrasound waves to gain an unbiased and user-independent estimate of tissue elasticity, which is considered advantageous compared to the mechanical pressure-based strain-elastography (SE) method [ 18 ].…”