Humanitas Clinical and Research Center - IRCCS, via Manzoni 56, Rozzano (Mi), Italy.
Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, Pieve Emanuele - Milan, Italy.
J Crohns Colitis. 2021 Jan 13;15(1):143-151. doi: 10.1093/ecco-jcc/jjaa151.
Inflammatory bowel diseases [IBD], including Crohn's disease [CD] and ulcerative colitis [UC], are chronic, relapsing and destructive inflammatory disorders of the gastrointestinal tract which can lead to organ damage and impair quality of life. A 'treat-to-target' strategy based on activity and severity of disease and response to treatment with close monitoring of intestinal inflammation is recommended. Ileocolonoscopy [CS] is considered the first-line procedure for the assessment of IBD, and magnetic resonance enterography [MRE] is the current standard for assessing the small bowel and complications in CD, and has been proposed as an alternative procedure to CS in the evaluation of both ileo-colonic CD and UC. As that both CS and MRE are invasive and expensive procedures and unappealing to patients, they are unfeasible as frequent and repetitive tools for the monitoring of disease activity. Bowel ultrasound [US] represents a well-tolerated, non-invasive and cost-effective modality to manage IBD patients in clinical practice. Compared to CS and MRE, bowel US has been shown to have the same level of accuracy in assessing and monitoring disease activity and severity of both CD and UC. It can be performed at the point-of-care and therefore allow for real-time clinical decision-making. Point-of-care ultrasound [POCUS] is suggested as the stethoscope of the future and is gaining interest and diffusion in the medical field because it can be used for the bedside examination of patients. The aim of this review is to discuss point-of-care bowel ultrasound [POCBUS] in the management of patients with IBD.
炎症性肠病（IBD），包括克罗恩病（CD）和溃疡性结肠炎（UC），是一种慢性、复发性和破坏性的胃肠道炎症性疾病，可导致器官损伤和生活质量下降。推荐采用基于疾病活动度和严重程度以及对治疗反应的“靶向治疗”策略，并密切监测肠道炎症。回结肠镜检查（CS）被认为是 IBD 评估的一线程序，磁共振肠造影术（MRE）是评估 CD 小肠和并发症的当前标准，并已被提议作为 CS 在评估回肠结肠 CD 和 UC 中的替代程序。由于 CS 和 MRE 均具有侵袭性且昂贵，并且对患者没有吸引力，因此它们不适宜作为监测疾病活动度的频繁且重复的工具。肠道超声（US）是一种可耐受、非侵入性且具有成本效益的方法，可用于临床实践中管理 IBD 患者。与 CS 和 MRE 相比，肠道 US 在评估和监测 CD 和 UC 的疾病活动度和严重程度方面具有相同的准确性。它可以在床边进行，因此可以实时进行临床决策。床边超声（POCUS）被认为是未来的听诊器，并且在医学领域越来越受到关注和普及，因为它可以用于患者的床边检查。本文的目的是讨论在 IBD 患者管理中使用床边肠道超声（POCBUS）。
