The Emerging Role of Ultrasonography in Ulcerative Colitis

Area of Science:

• Gastroenterology
• Medical Imaging
• Ultrasound Technology

Background:

• Ulcerative colitis (UC) management benefits from non-invasive monitoring techniques.
• Intestinal ultrasound (IUS) offers reliable assessment but has limitations in rectal evaluation.
• Transperineal ultrasonography (TPUS) and hand-held (HH) ultrasound enhance IUS utility.

Purpose of the Study:

• To review emerging applications of intestinal ultrasound (IUS) in ulcerative colitis (UC).
• To evaluate the role of IUS, TPUS, and HH ultrasound in UC management.
• To explore IUS utility in acute severe UC (ASUC) and postoperative pouch assessment.

Main Methods:

• Conducted a narrative review of studies on IUS in UC.
• Searched PubMed using keywords: "inflammatory bowel disease", "ulcerative colitis", "intestinal ultrasound", "TPUS", "HH", "point of care ultrasound", "bowel ultrasound".

Main Results:

• IUS effectively assesses UC disease activity and monitors treatment response.
• TPUS overcomes standard IUS limitations for rectal evaluation and pouch assessment.
• IUS is valuable in ASUC for assessing disease extension and early response to therapy.
• Hand-held (HH) ultrasound provides accurate point-of-care evaluation comparable to standard techniques.

Conclusions:

• IUS is an emerging, valuable tool for UC diagnosis, monitoring, and predicting disease course.
• TPUS and HH ultrasound are promising complementary technologies for UC management.
• Further multicenter validation is needed for routine clinical implementation of these ultrasound techniques.