Transperineal ultrasound(TPUS)is a non-invasive,real-time imaging technique increasingly utilized for the evaluation of anorectal and pelvic floor disorders in patients with inflammatory bowel disease(IBD).In ulcerati...Transperineal ultrasound(TPUS)is a non-invasive,real-time imaging technique increasingly utilized for the evaluation of anorectal and pelvic floor disorders in patients with inflammatory bowel disease(IBD).In ulcerative colitis,it enables accurate assessment of rectal wall thickness and vascularity,which correlate closely with both endoscopic and histological inflammation.This makes it a practical alternative to sigmoidoscopy,especially in settings such as pregnancy,childhood,or long-term disease monitoring.In Crohn’s disease,TPUS offers high diagnostic accuracy for detecting,classifying,and monitoring perianal fistulas and abscesses.It is also effective for evaluating rectovaginal fistulas and pouchrelated complications following restorative proctocolectomy.Advancements such as color Doppler imaging,contrast-enhanced ultrasound,three-dimensional reconstruction,and computer-assisted grayscale analysis further enhance its diagnostic and functional capabilities.Compared to magnetic resonance imaging and endoscopic ultrasound,TPUS serves as a practical,patient-friendly,and costeffective frontline or complementary imaging tool for comprehensive disease evaluation and treatment planning-particularly useful in children,pregnant women,and resource-limited settings.Its bedside feasibility,repeatability,and expanding role in treatment monitoring underscore its value in modern IBD care pathways.展开更多
BACKGROUND Postoperative recurrence is common in Crohn’s disease(CD),with endoscopic lesions in a majority of patients by 12 months after surgery.Ileocolonoscopy is the reference standard but is invasive and poorly s...BACKGROUND Postoperative recurrence is common in Crohn’s disease(CD),with endoscopic lesions in a majority of patients by 12 months after surgery.Ileocolonoscopy is the reference standard but is invasive and poorly suited to frequent surveillance.Intestinal ultrasound(IUS)-including small intestine contrast ultrasound and contrast enhanced ultrasound-is a repeatable,noninvasive alternative.AIM To summarize the evidence on the diagnostic accuracy and prognostic value of IUS for detecting postoperative recurrence in CD.METHODS We systematically searched PubMed and EMBASE through June 2025 for original English-language studies evaluating IUS against clinical or endoscopic outcomes in postoperative CD.This scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline.After screening 259 unique records,41 full texts were assessed and 20 studies were included.RESULTS Bowel wall thickness thresholds of≥5 mm at the neo-terminal ileum predict endoscopic recurrence with sensitivities 81%-94%and specificities 86%-100%;lower cutoffs at the anastomosis(≥3-3.5 mm)also carry risk(data from singlecenter cohorts).Dualsite assessment(neo-terminal ileum+ileocolonic anastomosis)improves performance.Adding Doppler hyperemia or mesenteric lymphadenopathy increases accuracy;combining bowel wall thickness≥3 mm with fecal calprotectin≥50μg/g yields high specificity(approximately 93%-100%)with a negative predictive value of nearly 95%when both are negative.Contrast enhanced ultrasound-based composite scores reach approximately 98%diagnostic accuracy in prospective cohorts.Small intestine contrast ultrasound shows similarly strong early diagnostic performance-for example,an area under the receiver operating characteristic curve up to 0.95 when using ileocolonic anastomosis wall thickness≥3 mm to 3.5 mm plus lesion length,with 82%-94%sensitivity and>90%specificity reported even within 7 days postresection.Overall,IUS shows moderate agreement with endoscopy(κapproximately 0.5-0.8)and stronger prognostic value when performed within 12 months post-surgery.CONCLUSION IUS can be integrated into postoperative surveillance algorithms-particularly within the first year-and can reduce routine endoscopy in selected patients.Research priorities include standardized thresholds and composite scoring,consensus training/competency,and multicenter validation including artificial intelligenceassisted interpretation.展开更多
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 revi...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 pro-gression,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 adva-ncements 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 ente-rography.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.Tech-niques 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 adjust-ments.Further studies are warranted to refine advanced techniques and standardize its application for broader use.展开更多
BACKGROUND Intestinal ultrasound(IUS)is an emerging,non-invasive,and highly sensitive diagnostic tool in inflammatory bowel disease(IBD),including ulcerative colitis(UC).Despite its potential,its adoption in clinical ...BACKGROUND Intestinal ultrasound(IUS)is an emerging,non-invasive,and highly sensitive diagnostic tool in inflammatory bowel disease(IBD),including ulcerative colitis(UC).Despite its potential,its adoption in clinical practice is limited due to a lack of standardization and awareness.AIM To perform a comprehensive scoping review based on a systematic literature review on IUS in UC to inform current practice.METHODS Ninety-nine original articles about ultrasonography in UC were identified among 7608 citations searching PubMed and EMBASE databases for systematic review.RESULTS IUS can be useful as an initial diagnostic strategy in patients with suspected IBD/UC.In UC,IUS can predict endoscopic response,histologic healing,and steroid responsiveness in acute severe cases.IUS can predict response to biologics/small molecules(as early as 2 wk).IUS correlates well with ileocolonoscopy,but IUS could miss rectal,jejunal,and upper GI lesions in suspected IBD and colon polyps or extra-intestinal manifestations in known IBD.IUS is useful in special situations(children,pregnancy,and postoperative Crohn's disease).Inter-observer agreement is acceptable and trained physicians have comparable diagnostic accuracy.Point-of-care ultrasound impacted management in 40%-60%of cases.Hand-held IUS has excellent agreement with conventional IUS.CONCLUSION IUS is a non-invasive,highly sensitive tool in the diagnosis and monitoring of UC,offering excellent patient satisfaction.Point-of-care ultrasound by IBD physicians can significantly impact clinical decision-making.展开更多
文摘Transperineal ultrasound(TPUS)is a non-invasive,real-time imaging technique increasingly utilized for the evaluation of anorectal and pelvic floor disorders in patients with inflammatory bowel disease(IBD).In ulcerative colitis,it enables accurate assessment of rectal wall thickness and vascularity,which correlate closely with both endoscopic and histological inflammation.This makes it a practical alternative to sigmoidoscopy,especially in settings such as pregnancy,childhood,or long-term disease monitoring.In Crohn’s disease,TPUS offers high diagnostic accuracy for detecting,classifying,and monitoring perianal fistulas and abscesses.It is also effective for evaluating rectovaginal fistulas and pouchrelated complications following restorative proctocolectomy.Advancements such as color Doppler imaging,contrast-enhanced ultrasound,three-dimensional reconstruction,and computer-assisted grayscale analysis further enhance its diagnostic and functional capabilities.Compared to magnetic resonance imaging and endoscopic ultrasound,TPUS serves as a practical,patient-friendly,and costeffective frontline or complementary imaging tool for comprehensive disease evaluation and treatment planning-particularly useful in children,pregnant women,and resource-limited settings.Its bedside feasibility,repeatability,and expanding role in treatment monitoring underscore its value in modern IBD care pathways.
文摘BACKGROUND Postoperative recurrence is common in Crohn’s disease(CD),with endoscopic lesions in a majority of patients by 12 months after surgery.Ileocolonoscopy is the reference standard but is invasive and poorly suited to frequent surveillance.Intestinal ultrasound(IUS)-including small intestine contrast ultrasound and contrast enhanced ultrasound-is a repeatable,noninvasive alternative.AIM To summarize the evidence on the diagnostic accuracy and prognostic value of IUS for detecting postoperative recurrence in CD.METHODS We systematically searched PubMed and EMBASE through June 2025 for original English-language studies evaluating IUS against clinical or endoscopic outcomes in postoperative CD.This scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline.After screening 259 unique records,41 full texts were assessed and 20 studies were included.RESULTS Bowel wall thickness thresholds of≥5 mm at the neo-terminal ileum predict endoscopic recurrence with sensitivities 81%-94%and specificities 86%-100%;lower cutoffs at the anastomosis(≥3-3.5 mm)also carry risk(data from singlecenter cohorts).Dualsite assessment(neo-terminal ileum+ileocolonic anastomosis)improves performance.Adding Doppler hyperemia or mesenteric lymphadenopathy increases accuracy;combining bowel wall thickness≥3 mm with fecal calprotectin≥50μg/g yields high specificity(approximately 93%-100%)with a negative predictive value of nearly 95%when both are negative.Contrast enhanced ultrasound-based composite scores reach approximately 98%diagnostic accuracy in prospective cohorts.Small intestine contrast ultrasound shows similarly strong early diagnostic performance-for example,an area under the receiver operating characteristic curve up to 0.95 when using ileocolonic anastomosis wall thickness≥3 mm to 3.5 mm plus lesion length,with 82%-94%sensitivity and>90%specificity reported even within 7 days postresection.Overall,IUS shows moderate agreement with endoscopy(κapproximately 0.5-0.8)and stronger prognostic value when performed within 12 months post-surgery.CONCLUSION IUS can be integrated into postoperative surveillance algorithms-particularly within the first year-and can reduce routine endoscopy in selected patients.Research priorities include standardized thresholds and composite scoring,consensus training/competency,and multicenter validation including artificial intelligenceassisted interpretation.
文摘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 pro-gression,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 adva-ncements 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 ente-rography.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.Tech-niques 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 adjust-ments.Further studies are warranted to refine advanced techniques and standardize its application for broader use.
文摘BACKGROUND Intestinal ultrasound(IUS)is an emerging,non-invasive,and highly sensitive diagnostic tool in inflammatory bowel disease(IBD),including ulcerative colitis(UC).Despite its potential,its adoption in clinical practice is limited due to a lack of standardization and awareness.AIM To perform a comprehensive scoping review based on a systematic literature review on IUS in UC to inform current practice.METHODS Ninety-nine original articles about ultrasonography in UC were identified among 7608 citations searching PubMed and EMBASE databases for systematic review.RESULTS IUS can be useful as an initial diagnostic strategy in patients with suspected IBD/UC.In UC,IUS can predict endoscopic response,histologic healing,and steroid responsiveness in acute severe cases.IUS can predict response to biologics/small molecules(as early as 2 wk).IUS correlates well with ileocolonoscopy,but IUS could miss rectal,jejunal,and upper GI lesions in suspected IBD and colon polyps or extra-intestinal manifestations in known IBD.IUS is useful in special situations(children,pregnancy,and postoperative Crohn's disease).Inter-observer agreement is acceptable and trained physicians have comparable diagnostic accuracy.Point-of-care ultrasound impacted management in 40%-60%of cases.Hand-held IUS has excellent agreement with conventional IUS.CONCLUSION IUS is a non-invasive,highly sensitive tool in the diagnosis and monitoring of UC,offering excellent patient satisfaction.Point-of-care ultrasound by IBD physicians can significantly impact clinical decision-making.
