Dolinger Michael T, Calabrese Emma, Pizzolante Fabrizio, Abreu Maria T
Susan and Leonard Feinstein Inflammatory Bowel Disease Center, Mount Sinai Hospital, Icahn School of Medicine, New York, New York.
Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Gastroenterol Hepatol (N Y). 2023 Aug;19(8):447-457.
Intestinal ultrasound (IUS) is a patient-centric, noninvasive, real-time, point-of-care tool with the capability to aid in diagnosis and monitoring of disease activity in both Crohn's disease and ulcerative colitis without the need for bowel preparation. IUS can be used as a tool for precision monitoring of inflammatory bowel disease (IBD) treatment response. IUS as a cross-sectional imaging tool is as accurate as magnetic resonance enterography (MRE) for assessing the ileum and is more accurate than MRE for colonic assessment proximal to the rectum. Multiple simple ultrasound-based scoring systems have been internally validated with endoscopy in both Crohn's disease and ulcerative colitis, and changes in IUS parameters can be seen as early as 2 weeks after treatment initiation. IUS also plays a unique role in IBD activity monitoring of patients in whom avoidance of invasive testing is paramount, such as children and pregnant patients. Novel uses go beyond monitoring activity, with potential use of elastography to measure bowel wall stiffness to detect fibrosis and bowel damage for enhanced decision-making. Ultimately, IUS is likely to expand in the United States, facilitated by accessible expert training, access to equipment, and the development of a reimbursement model. This article provides a comprehensive review of the current and novel uses of IUS in IBD.
肠道超声（IUS）是一种以患者为中心的非侵入性实时床旁检查工具，能够在无需肠道准备的情况下辅助诊断和监测克罗恩病和溃疡性结肠炎的疾病活动。IUS可作为精确监测炎症性肠病（IBD）治疗反应的工具。作为一种横断面成像工具，IUS在评估回肠方面与磁共振小肠造影（MRE）一样准确，而在评估直肠近端结肠方面比MRE更准确。多种基于超声的简单评分系统已在克罗恩病和溃疡性结肠炎中通过内镜进行了内部验证，并且在治疗开始后2周即可观察到IUS参数的变化。IUS在避免进行侵入性检查至关重要的患者（如儿童和孕妇）的IBD活动监测中也发挥着独特作用。IUS的新用途不仅限于监测疾病活动，弹性成像技术可能用于测量肠壁硬度以检测纤维化和肠道损伤，从而改善决策。最终，在美国，由于可获得专家培训、设备以及报销模式的发展，IUS的应用可能会得到推广。本文全面综述了IUS在IBD中的当前及新用途。
