Transperineal ultrasound: Role in inflammatory bowel disease management

Table 1 Studies evaluating transperineal ultrasound in pediatric perianal Crohn’s disease

Ref.	Patients (n)	Main findings	Concordance or accuracy vs MRI
Hwang et al[11], 2014	43	TPUS feasible in all; 47% with active fistula, 19% with abscess; well tolerated	No MRI comparison; pain severity correlated with activity
Lee et al[12], 2018	38	TPUS sensitivity 76% (fistula), 56% (abscess); better concordance with MRI than colonoscopy	κ = 0.296 for fistula, 0.624 for abscess
Jung et al[13], 2022	29	TPUS detected 80% of fistulas; excellent PPV (95%) and specificity (93%) for response	κ = 0.486; sensitivity 63%, accuracy 73%
Jung et al[13], 2022 (MRI/TPUS) analysis	56 fistulas analyzed	TPUS more likely to miss superficial/thin tracts; intersphincteric better detected	Detection correlated with thickness (P = 0.009); 80.4% of MRI fistulas seen on TPUS

TPUS: Transperineal ultrasound; MRI: Magnetic resonance imaging; PACD: Perianal Crohn’s disease; PPV: Positive predictive value, κ: Cohen’s kappa coefficient.