Intestinal ultrasound in Crohn’s disease: A systematic review of its role in diagnosis, monitoring, and treatment response

Le résumé fourni par la source

BACKGROUND Intestinal ultrasound (IUS) has gained prominence as a safe, non-invasive imaging technique for managing Crohn’s disease (CD), offering real-time evaluation without radiation exposure. AIM To systematically review the role of IUS in diagnosing, monitoring disease progression, assessing treatment response, and managing complications in CD. METHODS A literature search of PubMed and Embase databases was conducted, identifying 207 original research articles published between 1953 and June 2024. The review focused on diagnostic accuracy, disease monitoring, therapeutic utility, and advancements in IUS applications. RESULTS IUS has shown high diagnostic accuracy for detecting inflammation, particularly in the ileum and colon, with limitations in jejunal and rectal regions. It is effective in assessing disease activity using parameters like bowel wall thickness (BWT) and vascularity and correlates well with endoscopy and magnetic resonance enterography. IUS can predict early response to biologics, with reductions in BWT serving as an important marker. In known CD, IUS influences clinical decisions during remission, flares, and therapy evaluations. It reliably detects strictures, fistulas, and therapy-related complications. Small intestinal contrast ultrasound (SICUS) can improve the detection of strictures particularly proximal ones. Techniques such as CE-IUS and elastography enhance stricture characterization but require further validation. IUS is also useful in special scenarios like perianal fistulas, pregnancy, post-operative CD, and guiding endoscopic therapy. CONCLUSION IUS is a patient-friendly, cost-effective imaging tool that significantly impacts CD management across various stages. Its integration into clinical practice supports early diagnosis, disease monitoring, and therapeutic adjustments. Further studies are warranted to refine advanced techniques and standardize its application for broader use.

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