Department of Internal Medicine, Szent-Györgyi Albert Medical School, University of Szeged, Szeged, Hungary.
Curr Opin Gastroenterol. 2023 Jan 1;39(1):50-56. doi: 10.1097/MOG.0000000000000891. Epub 2022 Nov 3.
To revise recent literature findings regarding the use of ultrasound in colonic and perianal diseases by focusing particularly on its feasibility in inflammatory bowel diseases (IBD), colorectal neoplastic lesions, and perineal diseases, with further highlight on interventional capabilities.
Treat-to-target approach in IBD raised an interest in intestinal ultrasound (IUS) for monitoring bowel activity considering its noninvasive nature, low costs, and well tolerability. New IUS indices have been developed with ever better methodologies and are at various stage of validation. A standardized over-the-wire technique for colonic US using a flexible overtube enables endoscopic ultrasound (EUS)-guided tissue sampling beyond the rectum, and forward-viewing radial-array echoendoscopes can assist identification of early neoplastic lesions in proximal colon. Intraoperative ultrasound and contrast-enhanced ultrasound carry an additional diagnostic value compared to conventional preoperative imaging modalities in detecting colorectal cancer liver metastases (CRLM).
The feasibility of IUS in monitoring IBD activity is supported by growing evidence, but uniform IUS indices are still lacking. Recent advancements in EUS are expanding capabilities for determining depth of invasion of colorectal neoplasms, tissue sampling, and EUS-guided interventions to the entire colon. Ultrasonography can be a valuable tool in CRLM diagnostics as well.
本文特别关注超声在炎症性肠病（IBD）、结直肠肿瘤性病变和肛周疾病中的应用，重点介绍其在这些疾病中的可行性，并进一步强调其介入能力，从而更新关于超声在结直肠和肛周疾病中的应用的最新文献发现。
在 IBD 的靶向治疗方法中，鉴于超声的非侵入性、低成本和良好的耐受性，人们对肠超声（IUS）在监测肠道活动中的应用产生了兴趣。新的 IUS 指数已经使用更优的方法学开发出来，并处于不同的验证阶段。一种使用柔性外套管的经肛超声（TUS）标准化过线技术可实现直肠以外的内镜超声（EUS）引导下组织取样，前视径向阵列回声内镜可辅助识别近端结肠的早期肿瘤性病变。与传统术前成像方式相比，术中超声和超声造影在检测结直肠癌肝转移（CRLM）方面具有额外的诊断价值。
越来越多的证据支持 IUS 在监测 IBD 活动中的可行性，但仍缺乏统一的 IUS 指数。EUS 的最新进展扩大了确定结直肠肿瘤浸润深度、组织取样以及 EUS 引导下介入治疗整个结肠的能力。超声检查在 CRLM 诊断中也是一种有价值的工具。
