Abstract
Inflammatory bowel disease (IBD) is a chronic condition affecting primarily the gastrointestinal tract and characterized by growing incidence worldwide. Complex diagnostic process of IBD as well as evaluation of disease activity and intestinal complications that are crucial for the therapeutic decisions, require repetitive, invasive, expensive, time-consuming and poorly tolerated tests. In contrast to endoscopy and computed tomography, ultrasound elastography (UE) is non-invasive, non-radiating and non-contrasting dependent tool which might be utilized in IBD patients for the assessment of the intestinal changes. Therefore, we performed the systematic review to evaluate the possible application of the ultrasound elastography for assessment of the intestinal changes in IBD. After the search of three databases: PubMed, World of Knowledge and Scopus, we identified 12 papers which were included in the final analysis. The majority of the studies were focused on the evaluation of the symptomatic ileal/ileocolonic strictures in Crohn’s disease patients that required surgical resection. Only one study concerned ulcerative colitis. The authors evaluated different UE techniques: strain elastography (SE), acoustic radiation force impulse (ARFI) and shear wave elastography (SWE). Results were expressed with semi-quantitative color mapping and strain measurement. Histological scores of inflammation and fibrosis in Crohn’s disease were used as a reference test in the majority of studies. Ultrasound elastography seems to be a promising novel imaging technique supporting evaluation of the intestinal strictures in Crohn’s disease patients in respect to fibrosis detection as well as differentiation between fibrosis and inflammation. However, further research is needed to establish the position of ultrasound elastography in IBD management.
Highlights
As clinical symptoms poorly correlate with intestinal disease activity, this last one is evaluated by a set of laboratory indices (C-reactive protein (CRP), fecal calprotectin), endoscopy and imaging tests
A growing body of literature has investigated the applicability of ultrasound intestielastography in Crohn’s disease (CD) due to the whole wall inflammation and common fibrosis
Studies suggested that ultra(UEI), they implicated different reference methods
Summary
UC is a chronic mucosal and submucosal inflammation limited to the colon and rectum, whereas in CD, a whole intestinal wall is inflamed and every part of the gastrointestinal tract may be involved [2]. Still, both conditions share similar and not fully elucidated pathogenesis including interplay between genetic, microbiological and environmental factors. As clinical symptoms poorly correlate with intestinal disease activity, this last one is evaluated by a set of laboratory indices (C-reactive protein (CRP), fecal calprotectin), endoscopy and imaging tests. Assessment of the effectiveness of treatment strategy requires endoscopy as other indices of mucosal healing (MH) are still unavailable [6]
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