Guidelines Clinical Practice
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Mar 21, 2009; 15(11): 1319-1330
Published online Mar 21, 2009. doi: 10.3748/wjg.15.1319
Sonography of the small intestine
Kim Nylund, Svein Ødegaard, Trygve Hausken, Geir Folvik, Gülen Arslan Lied, Ivan Viola, Helwig Hauser, Odd-Helge Gilja
Kim Nylund, Trygve Hausken, Svein Ødegaard, Odd-Helge Gilja, National Centre for Ultrasound in Gastroenterology, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
Geir Folvik, Gülen Arslan Lied, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
Ivan Viola, Helwig Hauser, Institute of Informatics, University of Bergen, 5008 Bergen, Norway
Kim Nylund, Trygve Hausken, Svein Ødegaard, Odd-Helge Gilja, Institute of Medicine, University of Bergen, 5021 Bergen, Norway
Author contributions: All authors have contributed to the manuscript.
Correspondence to: Kim Nylund, Institute of Medicine, University of Bergen, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway.
Telephone: +47-55-973075
Fax: +47-55-972950
Received: December 17, 2008
Revised: January 26, 2009
Accepted: February 2, 2009
Published online: March 21, 2009

In the last two decades, there has been substantial development in the diagnostic possibilities for examining the small intestine. Compared with computerized tomography, magnetic resonance imaging, capsule endoscopy and double-balloon endoscopy, ultrasonography has the advantage of being cheap, portable, flexible and user- and patient-friendly, while at the same time providing the clinician with image data of high temporal and spatial resolution. The method has limitations with penetration in obesity and with intestinal air impairing image quality. The flexibility ultrasonography offers the examiner also implies that a systematic approach during scanning is needed. This paper reviews the basic scanning techniques and new modalities such as contrast-enhanced ultrasound, elastography, strain rate imaging, hydrosonography, allergosonography, endoscopic sonography and nutritional imaging, and the literature on disease-specific findings in the small intestine. Some of these methods have shown clinical benefit, while others are under research and development to establish their role in the diagnostic repertoire. However, along with improved overall image quality of new ultrasound scanners, these methods have enabled more anatomical and physiological changes in the small intestine to be observed. Accordingly, ultrasound of the small intestine is an attractive clinical tool to study patients with a range of diseases.

Keywords: Contrast-enhanced ultrasound, Crohn’s disease, Endoscopic sonography, Endosonography, Enteroclysis, Hydrosonography, Magnetic resonance imaging, Ultrasonography, Virtual endoscopy, Visualization