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

Table 14 Role of trans-perineal ultrasound in Crohn’s disease

Ref.	Design	No. of patients (CD)	Gold standard	Aim	Key results
Terracciano et al[178], 2016	Prospective	28	MRI	Fistula detection and classification, abscess detection	TPUS demonstrated strong correlation with MRI in detecting perianal fistulas, offering a non-invasive, patient-friendly approach for fistula detection with high diagnostic accuracy. TPUS was effective in identifying superficial and intersphincteric tracts, complementing MRI for complex disease
Mallohui et al[181], 2004	Prospective	19	EUA/MRI/FUP	Fistula and abscess detection	TPUS showed excellent concordance with MRI and EUA for detecting superficial abscesses and fistulas, providing real-time visualization. While MRI excelled in deep-seated abscesses, TPUS was invaluable in mapping superficial tracts and guiding management
Maconi et al[179], 2013	Prospective	59	MRI	Fistula detection and classification, abscess detection	TPUS demonstrated diagnostic accuracy comparable to MRI in detecting fistulas and abscesses. Its real-time imaging capability made it a suitable alternative in cases where MRI was contraindicated or unavailable
Maconi et al[180], 2007	Prospective	44	TRUS	Fistula detection and classification, abscess detection and classification	TPUS effectively identified internal openings and perianal abscesses, particularly in superficial fistulas. Its ease of use and non-invasive nature highlighted its utility in outpatient settings and as a complement to TRUS
Wedemeyer et al[183], 2004	Prospective	25	MRI	Fistula detection and classification, abscess detection and classification	TPUS demonstrated utility in identifying perianal fistulas and abscesses, though MRI provided additional details for complex and deep-seated lesions. TPUS was particularly effective in identifying inflammation and monitoring post-treatment changes
Stewart et al[182], 2001	Prospective	28/26	EUA/FUP	Fistula detection and classification, internal opening and abscess detection	TPUS was a valuable tool for detecting superficial fistulas and internal openings. Its real-time imaging capability complemented EUA by providing an additional, less invasive option for follow-up assessments

CD: Crohn’s disease; EUA: Examination under anesthesia; TPUS: Transperineal ultrasound; MRI: Magnetic resonance imaging.