Role of Ultrasound in Inflammatory Bowel Disease

Inflammatory Bowel Diseases

The aim of this article is to provide an extensive overview of the actual role of bowel ultrasound in the detection and follow-up of patients with chronic inflammatory bowel disease

The inflammatory bowel disease is a chronic bowel disorder; it can involve the whole gastrointestinal tract, but its localization in the ileum or colon is most common. The reference standard for the diagnosis of inflammatory bowel disease is ileocolonoscopy with histologic assessment. Dan Carter, Lior H. Katz, Eytan Bardan, Eti Salomon, Shulamit Goldstein, Shomron Ben Horin, Uri Kopylov, and Rami Eliakim The reference standard for the detection of any complications is surgery. However, imaging techniques have an important role both in the detection/localization of C D and in the followup of C D patients. In the last few years, the technical development of ultrasound equipment, the advent of new technologies such as elastography and mostly the increased expertise of sonographers have boosted the role of bowel ultrasound in assessment of the gastrointestinal tract. In fact, bowel ultrasound is particularly attractive thanks to its widespread availability, non-invasiveness, low cost and good reproducibility, as it can be easily repeated during follow-up Clara Benedetta Conti , Mariangela Giunta , Daniele Gridavilla , Dario Conte , Mirella Fraquelli . Bowel ultrasound has become the first-line imaging technique for patients with suspected C rohn's disease because it is cheap ,less radiation effect ,it can be done more than one time for follow up these patient . Some signs, for example, bowel loop elasticity (i.e., the capability of the bowel wall to collapse on the bowel lumen and return to the original size and shape after manual compression and decompression) and compressibility at probe contact and peristalsis (usually impaired), are not specific, whereas other signs, such as the characteristics of the bowel wall, are more specific. Among the latter, the most important sign is bowel wall thickening (BWT) . Also important are bowel wall echo pattern characteristics (BWP) , the presence of any margin irregularity and the grade of vascularity at echo color Doppler or power Doppler . Other yet less frequent signs are the luminal alterations, such as the distension or any luminal stenosis. Other possible findings outside the bowel loop are mesenteric hypertrophy , enlarged mesenteric lymph nodes and free fluid in the abdominal cavity or among the bowel loops .

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