The technique is also less expensive than MRI. This is known as point of care ultrasonography (POCUS), and it has been proven to speed up quality decision-making, both in initial diagnosis and in monitoring. 4Īnother great advantage is its immediacy, as it can be performed without any prior preparation. 3 In studies comparing the tolerance of the different diagnostic techniques in IBD, intestinal ultrasound comes first, at the same level as a blood test, and with a perceived utility similar to MRI. The excellent tolerance facilitates the use of ultrasound in IBD monitoring, enabling treatment to be adjusted based on the ultrasound assessment, and this has been associated with improvement in patients' clinical outcomes. It is very well tolerated by the patient, can be performed without specific preparation and is very accessible, cheap and non-invasive. Intestinal ultrasound has significant advantages in the diagnosis and assessment of IBD ( Table 1).
MIRIAM GUSO HOW TO
2 In view of the low level of implementation of abdominal ultrasound here in Spain, at the GETECCU ( Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa ) we have decided to review the advantages and disadvantages of the technique, the main findings and how to correctly interpret them, and the positioning of the technique in the management of IBD. Although MRI is common practice in most of Europe, the same cannot be said of ultrasound, the use of which varies greatly from country to country.
Options are limited to magnetic resonance imaging (MRI) and abdominal ultrasound. Consequently, the main consensus documents recommend performing an imaging test that complements colonoscopy, 1 preferably one which does not involve radiation. In Crohn's disease (CD) specifically, with its transmural nature and involvement of other bowel segments, this means that the study may be incomplete. The assessment is also limited to the colon and terminal ileum. 1 However, colonoscopy can only assess the mucosa and endoluminal findings. Colonoscopy is the recommended technique for both the initial diagnosis and the follow-up of IBD. Inflammatory bowel disease (IBD) is a chronic condition with exacerbations which, over time, can cause complications that lead to varying degrees of disability. A pesar de sus ventajas, su empleo en la enfermedad inflamatoria intestinal (EII) no está muy extendido en nuestro país, por este motivo el presente documento revisa las virtudes e inconvenientes de la técnica para favorecer su conocimiento e implantación en las Unidades de EII.
En la colitis ulcerosa su papel es menos relevante, limitándose a valorar la extensión y actividad cuando no sea posible o haya dudas con otras técnicas diagnósticas. Complementa a la colonoscopia en el diagnóstico y dada su tolerancia, coste e inmediatez, es una buena herramienta para la monitorización de la enfermedad. Tiene una buena correlación con las lesiones endoscópicas y permite la detección de complicaciones como estenosis, fístulas o abscesos. La ecografía tiene un excelente rendimiento diagnóstico tanto cuando se sospecha una enfermedad de Crohn como en la valoración de la actividad o en determinar su extensión y localización, muy similar a otras exploraciones como resonancia magnética o tomografía computarizada.
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