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.

Impact of intestinal ultrasound on the management of patients with inflammatory bowel disease: how to apply scientific evidence to clinical practice / M. Fraquelli, F. Castiglione, E. Calabrese, G. Maconi. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 52:1(2020 Jan), pp. 9-18. [10.1016/j.dld.2019.10.004]

Impact of intestinal ultrasound on the management of patients with inflammatory bowel disease: how to apply scientific evidence to clinical practice

G. Maconi
Ultimo
2020

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.
IBD; Inflammatory bowel disease; Intestinal ultrasound; Contrast Media; Humans; Inflammatory Bowel Diseases; Intestines; Prognosis; Ultrasonography
Settore MED/12 - Gastroenterologia
gen-2020
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/810754
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