Intestinal Ultrasound and its Application as Point-of-Care Procedure for Diagnosing and Detecting Inflammatory Bowel Disease and Related Complications: A Narrative Review
Main Article Content
Abstract
Inflammatory bowel disease, comprising Crohn's disease and ulcerative colitis, defines as an idiopathic, chronic, relapsing, inflammatory disease affecting the gastrointestinal tract and leading to chronic damage. Endoscopy with biopsies is considered the gold standard for inflammatory bowel disease diagnosis, whereas magnetic resonance for Crohn’s disease extension and complication assessment. However, colonoscopy is an invasive procedure, while magnetic resonance is relatively not easily accessible for patients; thus, the need for a reliable, accessible and non-invasive way to perform inflammatory bowel diseases diagnosis and monitoring in the tight control era, like intestinal ultrasound is. Compared to endoscopy and magnetic resonance, ultrasound has shown reliable diagnostic accuracy in assessing Crohn’s disease diagnosis and evaluation of localisation, extension and complications. On the other hand, intestinal ultrasound is emerging as a valid tool also for ulcerative colitis severity and extension assessment. Moreover, performing ultrasonography in a point-of-care setting can guide the clinician in driving the diagnostic and therapeutic pathway, thus accelerating clinical decisions. As a novelty, point-of-care intestinal ultrasound performed with pocket devices could represent a promising item for the future of physical examination in outpatient or inpatient examination. The need for reproducibility of intestinal ultrasound among sonographers has emerged as a key-point in inflammatory bowel disease research field: the development of new scores for the evaluation of disease severity together with an intensive dedicated trainship could potentially reduce the differences between clinicians reporting.
Accordingly, our aim was to perform a narrative review about the application of intestinal ultrasound in Crohn’s disease and ulcerative colitis diagnosis and monitoring. Furthermore, technical aspects of this imaging technique and its application in a point-of-care setting through traditional and handheld sonographers were explored.
Keywords:
IBD, Crohn, Ulcerative colitis, diagnosis, intestinal ultrasonography, POCIUS
Article Details
How to Cite
RISPO, Antonio et al.
Intestinal Ultrasound and its Application as Point-of-Care Procedure for Diagnosing and Detecting Inflammatory Bowel Disease and Related Complications: A Narrative Review.
Medical Research Archives, [S.l.], v. 11, n. 10, oct. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4472>. Date accessed: 23 nov. 2024.
doi: https://doi.org/10.18103/mra.v11i10.4472.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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2. Turner D, Ricciuto A, Lewis A, et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology. 2021;160(5):1570-1583. doi:10.1053/j.gastro.2020.12.031
3. Maaser C, Sturm A, Vavricka SR, et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. Journal of Crohn’s and Colitis. 2019;13(2):144-164K. doi:10.1093/ecco-jcc/jjy113
4. Magro F, Gionchetti P, Eliakim R, et al. Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 1: Definitions, Diagnosis, Extra-intestinal Manifestations, Pregnancy, Cancer Surveillance, Surgery, and Ileo-anal Pouch Disorders. Journal of Crohn’s and Colitis. 2017;11(6):649-670. doi:10.1093/ecco-jcc/jjx008
5. Rimola J, Torres J, Kumar S, Taylor SA, Kucharzik T. Recent advances in clinical practice: advances in cross-sectional imaging in inflammatory bowel disease. Gut. Published online August 4, 2022:gutjnl-2021-326562. doi:10.1136/gutjnl-2021-326562
6. Bots S, De Voogd F, De Jong M, et al. Point-of-care Intestinal Ultrasound in IBD Patients: Disease Management and Diagnostic Yield in a Real-world Cohort and Proposal of a Point-of-care Algorithm. Journal of Crohn’s and Colitis. 2022;16(4):606-615. doi:10.1093/ecco-jcc/jjab175
7. de Voogd FAE, Verstockt B, Maaser C, Gecse KB. Point-of-care intestinal ultrasonography in inflammatory bowel disease. Nat Rev Gastroenterol Hepatol. 2021;18(4):209-210. doi:10.1038/s41575-021-00418-4
8. Nardone OM, Calabrese G, Testa A, et al. The Impact of Intestinal Ultrasound on the Management of Inflammatory Bowel Disease: From Established Facts Toward New Horizons. Front Med. 2022;9:898092. doi:10.3389/fmed.2022.898092
9. Allocca M, Furfaro F, Fiorino G, Peyrin-Biroulet L, Danese S. Point-of-Care Ultrasound in Inflammatory Bowel Disease. Journal of Crohn’s and Colitis. 2021;15(1):143-151. doi:10.1093/ecco-jcc/jjaa151
10. Allocca M, Kucharzik T, Rubin DT. Intestinal Ultrasound in the Assessment and Management of Inflammatory Bowel Disease: Is It Ready for Standard Practice? Gastroenterology. 2023;164(6):851-855. doi:10.1053/j.gastro.2023.01.021
11. Kucharzik T, Tielbeek J, Carter D, et al. ECCO-ESGAR Topical Review on Optimizing Reporting for Cross-Sectional Imaging in Inflammatory Bowel Disease. Journal of Crohn’s and Colitis. 2022;16(4):523-543. doi:10.1093/ecco-jcc/jjab180
12. Maconi G, Parente F, Bollani S, Cesana B, Bianchi Porro G. Abdominal ultrasound in the assessment of extent and activity of Crohn’s disease: clinical significance and implication of bowel wall thickening. Am J Gastroenterol. 1996;91(8):1604-1609.
13. Astegiano M, Bresso F, Cammarota T, et al. Abdominal pain and bowel dysfunction: diagnostic role of intestinal ultrasound: European Journal of Gastroenterology & Hepatology. 2001;13(8):927-931. doi:10.1097/00042737-200108000-00009
14. Parente F. Bowel ultrasound in assessment of Crohn’s disease and detection of related small bowel strictures: a prospective comparative study versus x ray and intraoperative findings. Gut. 2002;50(4):490-495. doi:10.1136/gut.50.4.490
15. Pascu M, Roznowski AB, Müller HP, Adler A, Wiedenmann B, Dignass AU. Clinical Relevance of Transabdominal Ultrasonography and Magnetic Resonance Imaging in Patients With Inflammatory Bowel Disease of the Terminal Ileum and Large Bowel: Inflammatory Bowel Diseases. 2004;10(4):373-382. doi:10.1097/00054725-200407000-00008
16. Pallotta N, Tomei E, Viscido A, et al. Small Intestine Contrast Ultrasonography: An Alternative to Radiology in the Assessment of Small Bowel Disease. Inflammatory Bowel Diseases. 2005;11(2):146-153. doi:10.1097/00054725-200502000-00008
17. Rispo A, Imbriaco M, Celentano L, et al. Noninvasive Diagnosis of Small Bowel Crohnʼs Disease: Combined Use of Bowel Sonography and Tc-99M-Hmpao Leukocyte Scintigraphy: Inflammatory Bowel Diseases. 2005;11(4):376-382. doi:10.1097/01.MIB.0000164020.65106.84
18. Castiglione F, Mainenti PP, De Palma GD, et al. Noninvasive Diagnosis of Small Bowel Crohn’s Disease: Direct Comparison of Bowel Sonography and Magnetic Resonance Enterography. Inflammatory Bowel Diseases. 2013;19(5):991-998. doi:10.1097/MIB.0b013e3182802b87
19. Pallotta N, Civitelli F, Di Nardo G, et al. Small Intestine Contrast Ultrasonography in Pediatric Crohn’s Disease. The Journal of Pediatrics. 2013;163(3):778-784.e1. doi:10.1016/j.jpeds.2013.03.056
20. Rispo A, de Sire R, Mainenti PP, et al. David Against Goliath: Direct Comparison of Handheld Bowel Sonography and Magnetic Resonance Enterography for Diagnosis of Crohn’s Disease. Inflammatory Bowel Diseases. Published online June 6, 2022:izac116. doi:10.1093/ibd/izac116
21. Calabrese E, Maaser C, Zorzi F, et al. Bowel Ultrasonography in the Management of Crohnʼs Disease. A Review with Recommendations of an International Panel of Experts: Inflammatory Bowel Diseases. 2016;22(5):1168-1183. doi:10.1097/MIB.0000000000000706
22. Taylor SA, Mallett S, Bhatnagar G, et al. Diagnostic accuracy of magnetic resonance enterography and small bowel ultrasound for the extent and activity of newly diagnosed and relapsed Crohn’s disease (METRIC): a multicentre trial. The Lancet Gastroenterology & Hepatology. 2018;3(8):548-558. doi:10.1016/S2468-1253(18)30161-4
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