Intestinal ultrasound in Crohn’s disease: A systematic review of its role in diagnosis, monitoring, and treatment response

Table 12 Summary of studies on intestinal ultrasound in pediatric inflammatory bowel disease

Ref.	Study type	Number of patients	Follow up	Gold standard	Com parator	Results
Borthne et al[158], 2006	Prospective	43 children	3 weeks	Endoscopy	MRI	MRI with 300 mL mannitol and IUS both had good correlation with colonoscopy for terminal ileum
Maccioni et al[145], 2014	Prospective	50 known pediatric CD	MRE done within 15 days	Capsule endoscopy barium study	MRE	MRE identified jejunal lesions not detected in HRUS (n = 2), False positive MRE findings in proximal to mid ileum (n = 1) 100% sensitivity and specificity of MRE in terminal ileum
Rosenbaum et al[132], 2017	Retrospective	98 Pediatric CD	2 months of each other	Surgical biopsy	MRE	Increased BWT, loss of BWS and fibrofatty proliferation on IUS in surgical vs non-surgical patients
Barber et al[159], 2017	Retrospective	49 IBD	30 days	MRE	Endoscopy and histology	Good correlation between MRE and IUS on the location and severity of disease
Dillman et al[162], 2017	Prospective cross-sectional study	28 pediatrics	2 weeks, 1 month, 3 months and 6 months on infliximab			BWT, length of bowel involved, bowel and mesenteric colour doppler signal changes as early as 2 weeks of infliximab therapy. Storing correlation between CDS intensity and fecal calprotectin
van Wassenaer et al[164], 2023	Prospective	74 CD	Cross-sectional	SES-CD score	Ileo-colonoscopy	PCD-US score. Based on BWT in TI. And BWT + mesenteric fat infiltration in colon. Cut-off 1: Sensitivity 82% (TI), 85% (colon). Cut-off 3: Specificity: 88% (TI), 92% colon. External validation required
Dolinger et al[163], 2023	Prospective longitudinal	44 children	1 year	Endoscopy (SES-CD)	PCDAI, CRP	≥ 18% decrease in BWT at week 8 predicted endoscopic remission with AUROC 0.99
Dolinger et al[112], 2021	Prospective cohort	13 children	14 weeks	Clinical remission	SBUS	Bowel wall hyperemia decreased post-induction (P = 0.01). No correlation was seen with changes in BWT
Okuhira et al[166], 2022	Retrospective	22 procedures	Not specified	SBCE	IUS, biomarkers	SBWT and mesenteric lymph node size correlated with Lewis Score (r = 0.52 and r = 0.45, respectively)
Pallotta et al[155], 2013	Prospective cohort	51 pediatric patients	Cross-sectional	Small bowel follow-through	SICUS	SICUS sensitivity and specificity for CD lesions were 96% and 100%, superior to TUS (sensitivity 76%)
Ponorac et al[48], 2023	Prospective cohort	36 children	30 days	Endoscopy (SES-CD)	CEUS, PCDAI, FC	CEUS sensitivity 78.57%, specificity 100%. Concordance with endoscopy was substantial (κ = 0.62)

CD: Crohn’s disease; TI: Terminal ileum; IUS: Intestinal ultrasound; MRE: Magnetic resonance enterography; BWT: Bowel wall thickness; PCD: Pediatric Crohn’s disease; BWS: Bowel wall stratification; CDS: Colour doppler signal; MRI: Magnetic resonance imaging; HRUS: High-resolution ultrasonography; IBD: Inflammatory bowel disease; SES-CD: Simple endoscopic score for Crohn’s disease; PCD-US: Pediatric Crohn’s disease intestinal ultrasound score; PCDAI: CRP: C-reactive protein; AUROC: SBUS: Small bowel ultrasound; SBCE: Small bowel capsule endoscopy; SICUS: Small intestinal contrast ultrasound; CEUS: Contrast enhanced ultrasound; FC: Fecal calprotectin; TUS: Traditional ultrasound.