This white paper presents a structured protocol for using intestinal ultrasound (IUS) to support the diagnosis and monitoring of inflammatory bowel disease (IBD). Authored by Prof. Michael Todd Dolinger, it provides technical guidance on performing high-quality IUS imaging for patients with Crohn’s disease or ulcerative colitis.
The protocol begins by specifying the required ultrasound systems (Samsung RS85 Prestige, V8, and compatible transducers) and optimal frequency settings for bowel imaging. It then details key IUS parameters essential for IBD evaluation:
- Bowel Wall Thickness (BWT): Measured in longitudinal or cross-sectional planes, with >3 mm in adults considered abnormal.
- Bowel Wall Hyperemia: Evaluated using color Doppler and graded with the modified Limberg score (0–3 scale).
- Bowel Wall Stratification: Loss or disruption of normal layers signals active disease; findings include flattening of haustral folds or spiculations.
- Inflammatory Mesenteric Fat and Lymphadenopathy: Visual cues of disease activity, classified by presence and severity.
- Complications: Detection of strictures, fistulas, and pre-stenotic dilation through targeted imaging techniques.
The document emphasizes reproducibility and standardization in IUS acquisition and interpretation, enabling accurate clinical decision-making. It also describes how cine loops and still images should be acquired and annotated for thorough segmental evaluation of the colon and small bowel.
Overall, the protocol positions IUS as a powerful, radiation-free tool for managing inflammatory bowel disease, offering real-time, non-invasive insight into disease extent and activity.
For clinical insights into how intestinal ultrasound is used to assess disease activity and monitor treatment response in IBD, see the related white paper on intestinal ultrasound in IBD monitoring and treatment .
