Accuracy of Bowel Ultrasound for Detecting Inflammatory Bowel Disease at a Tertiary Hospital in Central South Africa.

Abstract

Background: To prevent complications, early diagnosis and treatment of inflammatory bowel disease (IBD) are crucial. The gold standard for diagnosis is colonoscopy with biopsy, which is invasive and costly. Bowel ultrasound (BUS) is a non-invasive and accurate diagnostic imaging tool. Thus, the aim of this study was to evaluate the accuracy of BUS in detecting IBD, compared to the gold standard of colonoscopy with biopsy.

Objectives: A BUS imaging protocol for IBD was used to make a preliminary diagnosis of IBD with a BUS scan. The preliminary diagnoses were compared to the confirmatory diagnoses that used histology.

Method: A radiologist made a preliminary diagnosis using the instrument BUS parameter measurements. Fisher's exact test (p = 0.05) was performed to determine if an association existed between the preliminary IBD diagnosis and confirmation. The accuracy of BUS diagnosis was calculated for the individual parameters and the preliminary ultrasound diagnosis.

Results: Of the participants, 47 (61%) were diagnosed with IBD, and 30 (39%) were negative. The majority had thickened bowel walls and increased bowel wall vascularity. The BUS parameters of bowel wall thickness and vascularity accuracy were above 80%. Bowel wall stratification, haustration, fatty wrapping, peristalsis, mesenteric lymph nodes, and free fluid ranged between 66% and 71%. The overall accuracy of BUS parameters exceeded 80%.

Conclusion: The potential of using BUS parameters as a sifting or screening tool should be considered in the workup to expedite the diagnosis of IBD.

Contribution: The identification and description of BUS parameters for ultrasound diagnosis of IBD may facilitate the diagnosis and monitoring of IBD.