Title:Application of Ultrasound Elastography for Assessing Intestinal Fibrosis in Inflammatory Bowel Disease: Fiction or Reality?
VOLUME: 22 ISSUE: 3
Author(s):Roberto Gabbiadini, Eirini Zacharopoulou, Federica Furfaro, Vincenzo Craviotto, Alessandra Zilli, Daniela Gilardi, Giulia Roda, Laura Loy, Gionata Fiorino, Laurent Peyrin-Biroulet, Silvio Danese and Mariangela Allocca*
Affiliation:Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano (Mi), Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano (Mi), Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano (Mi), Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano (Mi), Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano (Mi), Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano (Mi), Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano (Mi), Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano (Mi), Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano (Mi), Department of Gastroenterology and Inserm U954, University Hospital of Nancy, Lorraine University, Nancy, Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano (Mi), Humanitas Clinical and Research Center – IRCCS -, via Manzoni 56, 20089 Rozzano (Mi)
Keywords:Inflammatory bowel disease (IBD), Crohn's disease (CD), Ultrasound elastography (USE), heterogeneity, fibrosis,
therapeutic strategy.
Abstract:
Background: Intestinal fibrosis and subsequent strictures represent an important burden
in inflammatory bowel disease (IBD). Both the detection and evaluation of the degree of fibrosis in
stricturing Crohn’s disease (CD) are important when deciding the best therapeutic strategy (medical
anti-inflammatory therapy, endoscopic dilation, surgery). Ultrasound elastography (USE) is a
non-invasive technique that has been proposed in the field of IBD for evaluating intestinal stiffness
as a biomarker of intestinal fibrosis.
Objective: The aim of this review is to discuss the ability and
current role of ultrasound elastography in the assessment of intestinal fibrosis. Results and Conclusion:
Data on USE in IBD are provided by pilot and proof-of-concept studies with small sample
size. The first type of USE investigated was strain elastography, while shear wave elastography has
been introduced recently. Despite the heterogeneity of the methods of the studies, USE has been
proven to be able to assess intestinal fibrosis in patients with stricturing CD. However, before introducing
this technique in current practice, further studies with larger sample sizes are needed. In addition,
the use of homogeneous parameters, the assessment of reproducibility, and the identification
of validated cut-off values are essential.