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Gut. 2018 May;67(5):973-985. doi: 10.1136/gutjnl-2017-315655. Epub 2018 Feb 3.

Gastrointestinal ultrasound in inflammatory bowel disease: an underused resource with potential paradigm-changing application.

Author information

1
Department of Gastroenterology, The Queen Elizabeth Hospital, Adelaide, Australia.
2
Faculty of Health Sciences, School of Medicine, University of Adelaide, Adelaide, Australia.
3
Department of Gastroenterology, Alfred Hospital, Melbourne, Australia.
4
Central Clinical School, Monash University, Melbourne, Australia.
5
Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.
6
University of Melbourne, Melbourne, Australia.
7
Department of Gastroenterology, Mater Hospital, Brisbane, Australia.
8
Mater Research Institute, University of Queensland, Brisbane, Australia.
9
Department of Gastroenterology, Luigi Sacco University Hospital, Milan, Italy.
10
Department of General Internal Medicine and Gastroenterology, University Teaching Hospital Lueneburg, Lueneburg, Germany.
11
Division of Gastroenterology, University of Calgary, Calgary, Canada.
12
Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK.
13
Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Australia.

Abstract

Evolution of treatment targets in IBD has increased the need for objective monitoring of disease activity to guide therapeutic strategy. Although mucosal healing is the current target of therapy in IBD, endoscopy is invasive, expensive and unappealing to patients. GI ultrasound (GIUS) represents a non-invasive modality to assess disease activity in IBD. It is accurate, cost-effective and reproducible. GIUS can be performed at the point of care without specific patient preparation so as to facilitate clinical decision-making. As compared with ileocolonoscopy and other imaging modalities (CT and MRI), GIUS is accurate in diagnosing IBD, detecting complications of disease including fistulae, strictures and abscesses, monitoring disease activity and detecting postoperative disease recurrence. International groups increasingly recognise GIUS as a valuable tool with paradigm-changing application in the management of IBD; however, uptake outside parts of continental Europe has been slow and GIUS is underused in many countries. The aim of this review is to present a pragmatic guide to the positioning of GIUS in IBD clinical practice, providing evidence for use, algorithms for integration into practice, training pathways and a strategic implementation framework.

KEYWORDS:

Inflammatory bowel disease; gastrointestinal ultrasound; mucosal healing

PMID:
29437914
DOI:
10.1136/gutjnl-2017-315655
[Indexed for MEDLINE]

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