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World J Gastroenterol. Oct 14, 2017; 23(38): 6931-6941
Published online Oct 14, 2017. doi: 10.3748/wjg.v23.i38.6931
How to perform gastrointestinal ultrasound: Anatomy and normal findings
Nathan S S Atkinson, Robert V Bryant, Yi Dong, Christian Maaser, Torsten Kucharzik, Giovanni Maconi, Anil K Asthana, Michael Blaivas, Adrian Goudie, Odd Helge Gilja, Dieter Nuernberg, Dagmar Schreiber-Dietrich, Christoph F Dietrich
Nathan S S Atkinson, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, United Kingdom
Robert V Bryant, School of Medicine, University of Adelaide, Adelaide, South Australia, 5005, Australia
Robert V Bryant, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide 5000, Australia
Yi Dong, Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Christian Maaser, Ambulanzzentrum Gastroenterologie, Klinikum Lüneburg, 21339 Lüneburg, Germany
Torsten Kucharzik, Department of Gastroenterology, Städtisches Klinikum Luneburg gGmbH, 21339 Lüneburg, Germany
Giovanni Maconi, Gastrointestinal Unit, Department of Biomedical and Clinical Sciences, “L.Sacco” University Hospital, 20157 Milan, Italy
Anil K Asthana, Department of Gastroenterology and Hepatology, The Alfred Hospital, Melbourne, Vic, Australia; Monash University, Melbourne 3004 Vic, Australia
Michael Blaivas, Piedmont Hospital, Department of Emergency Medicine, Atlanta, GA 30076, United States
Adrian Goudie, Fremantle Hospital and Health Service, Emergency Department, Fremantle, WA 6160, United States
Odd Helge Gilja, National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen N-5021, Norway
Odd Helge Gilja, Department of Clinical Medicine, University of Bergen, 5021 Bergen, Norway
Dieter Nuernberg, Department of Gastroenterology, Brandenburg Medical School, 16816 Neuruppin, Germany
Dagmar Schreiber-Dietrich, Christoph F Dietrich, Med. Klinik 2, Caritas-Krankenhaus Bad Mergentheim, D-97980 Bad Mergentheim, Germany
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Christoph F Dietrich, MD, PhD, Med. Klinik 2, Caritas-Krankenhaus Bad Mergentheim, Uhlandstr. 7, D-97980 Bad Mergentheim, Germany. christoph.dietrich@ckbm.de
Telephone: +49-7931-582201-2200 Fax: +49-7931-582290
Received: February 9, 2017
Peer-review started: February 11, 2017
First decision: April 25, 2017
Revised: May 30, 2017
Accepted: June 18, 2017
Article in press: June 19, 2017
Published online: October 14, 2017
Abstract

Gastrointestinal ultrasound is a practical, safe, cheap and reproducible diagnostic tool in inflammatory bowel disease gaining global prominence amongst clinicians. Understanding the embryological processes of the intestinal tract assists in the interpretation of abnormal sonographic findings. In general terms, the examination principally comprises interrogation of the colon, mesentery and small intestine using both low-frequency and high-frequency probes. Interpretation of findings on GIUS includes assessment of bowel wall thickness, symmetry of this thickness, evidence of transmural changes, assessment of vascularity using Doppler imaging and assessment of other specific features including lymph nodes, mesentery and luminal motility. In addition to B-mode imaging, transperineal ultrasonography, elastography and contrast-enhanced ultrasonography are useful adjuncts. This supplement expands upon these features in more depth.

Keywords: Ultrasound, Intestinal, Inflammatory bowel disease, Guidelines, Teaching

Core tip: In general terms, gastrointestinal ultrasound examination principally comprises interrogation of the colon, mesentery and small intestine using both low-frequency and high-frequency probes. In addition to B-mode imaging, transperineal ultrasonography, elastography and contrast-enhanced ultrasonography are useful adjuncts.