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Bowel Thickening in Crohn's Disease: Fibrosis or Inflammation? Diagnostic Ultrasound Imaging Tools
Rosa Coelho1, Helena Ribeiro, Giovanni Maconi
1*Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal; †Department of Gastroenterology, Amato Lusitano Hospital, Castelo Branco, Portugal; and ‡Gastrointestinal Unit, Department of Biomedical and Clinical Sciences, Luigi Sacco University Hospital, University of Milan, Milan, Italy.
Abstract:
The high frequency of intestinal strictures in patients with Crohn's disease and the different treatment approaches specific for each type of stenosis make the differentiation between fibrotic and inflammatory strictures crucial in management of the disease. However, there is no standardized approach to evaluate and discriminate intestinal strictures, and until now, there was no established cross-sectional imaging modality to detect fibrosis. New techniques, such as contrast-enhanced ultrasound and sonoelastography allow the assessment of vascularization and mechanical properties of stenotic bowel tissue, respectively. These techniques have shown great potential to characterize strictures in Crohn's disease. The aim of this review is to sum up the current knowledge on bowel ultrasound tools to discriminate inflammatory from fibrotic stenosis in Crohn's disease considering the most recent published studies in the field.
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