Abstract
Bowel ultrasound (BUS) is a non-invasive and accurate technique for assessing activity, extension of disease, and complications in inflammatory bowel diseases. The main advantages of BUS are its safety, reproducibility, and low costs. Ancillary technologies of BUS (i.e., color Doppler and wave elastography) could broaden the diagnostic power of BUS, allowing one to distinguish between inflammation and fibrosis. Considering the costs and invasiveness of colonoscopy and magnetic resonance, BUS appears as a fast, safe, and accurate technique. The objective measures of disease allow one to make clinical decisions, such as optimization, switch, or swap of therapy. Previous studies reported a sensitivity and a specificity of more than 90% compared to endoscopy and magnetic resonance. Lastly, transperineal ultrasound (TPUS) is a promising approach for the evaluation of perianal disease in Crohn’s disease (CD) and disease activity in patients with ulcerative proctitis or pouchitis. Bowel ultrasound is being incorporated in the algorithm of managing inflammatory bowel diseases. Transmural healing evaluated through ultrasonography is emerging as a complementary target for disease treatment. In this review, we aimed to summarize and discuss the current evidence on BUS in the management of inflammatory bowel diseases and to address the challenges of a full validation of this technique.
Highlights
Inflammatory bowel diseases (IBD) are chronic, progressive, and disabling conditions, characterized by a relapsing and remitting behavior and long-term complications [1,2]
We aim to examine and summarize the technical aspects and the current evidence on bowel ultrasound (BUS) in the management of IBD, focusing on the detection of disease activity, complications, and the newly emerging transperineal approach
The normal bowel is stratified with five concentric layers that can be distinguished for their echogenicity (Figure 1): the most inner layer identifies the hyperechoic mucosa/lumen interface, while the most outer layer is an echogenic interface between the serosa and the confining organs or structures [15,16]
Summary
Inflammatory bowel diseases (IBD) are chronic, progressive, and disabling conditions, characterized by a relapsing and remitting behavior and long-term complications (i.e., colo-rectal cancer and demolitive surgery) [1,2]. Ultrasound was not considered a valid method for the assessment of the small bowel and colon [7]. It has taken a long time since the first studies in the 1970s on the effectiveness of this technique for bowel examination and its recent scientific acknowledgement [7]. Current recommendations recognize BUS as a valid method for the assessment of the small bowel in newly diagnosed CD and, generally, for the monitoring of IBD [8]; a standardization of the intestinal and extraintestinal features of active disease is still needed. We aim to examine and summarize the technical aspects and the current evidence on BUS in the management of IBD, focusing on the detection of disease activity, complications, and the newly emerging transperineal approach
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
