Systematic review: Clinical utility of gastrointestinal ultrasound in the diagnosis, assessment and management of patients with ulcerative colitis.
J Crohns Colitis. 2019 Sep 28;:
Authors: Smith RL, Taylor KM, Friedman AB, Gibson RN, Gibson PR
BACKGROUND: Gastrointestinal ultrasound is useful in the assessment of patients with Crohn’s disease, but its application in ulcerative colitis is less well established.
AIM: To systematically review the role of gastrointestinal ultrasound in patients with ulcerative colitis.
METHODS: Searches of the PUBMED and EMBASE database were performed with the following search strategy: (ultrasound OR sonography) AND (intestinal OR bowel) AND (ulcerative colitis OR Inflammatory bowel disease). The final search was performed in August 2019.
RESULTS: Of 6769 studies identified in the search with 2 further studies found from other sources, 50 studies met inclusion criteria. Increased bowel wall thickness and detection of increased blood flow by colour Doppler were most often applied criteria for defining disease activity and distribution. When compared with other reference investigations, gastrointestinal ultrasound accurately determined disease extent, severity and response to medical therapy. While further information can be obtained from haemodynamic measurements of the abdominal vessels and contrast-enhanced ultrasound, their clinical value was uncertain. Likewise, hydrocolonic sonography has few advantages over standard GIUS examination. Of several scoring systems proposed, there is disparity between the measures and a general lack of validation. There has been limited application of gastrointestinal ultrasound in acute severe ulcerative colitis with toxic megacolon, and, while performing well in children, normal limits differ to those in adults.
CONCLUSION: Current evidence indicates that gastrointestinal ultrasound has utility in the non-invasive assessment of patients with ulcerative colitis. Continued advances in technology with better image resolution, validation of scoring systems and application at the point of care by gastroenterologists are likely to contribute to increased use of gastrointestinal ultrasound in routine clinical practice.
PMID: 31562739 [PubMed – as supplied by publisher]