Diagnostic utility of bowel ultrasonography in adults with inflammatory bowel disease: An updated systematic review and meta‐analysis
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: BACKGROUND: Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), necessitates frequent disease monitoring to guide management. While colonoscopy remains the gold standard for assessing disease activity, its invasive nature limits its feasibility. Bowel ultrasonography (BUS) has emerged as a noninvasive alternative. OBJECTIVE: This systematic review and meta-analysis evaluate the diagnostic accuracy of BUS in detecting IBD activity compared to colonoscopy. METHODS: A comprehensive literature search of PubMed, CINAHL and Embase was conducted, including 37 studies evaluating BUS modalities such as colour Doppler, small intestine contrast ultrasonography (SICUS) and contrast-enhanced ultrasound (CEUS). Pooled sensitivity, specificity, diagnostic odds ratios (DOR) and likelihood ratios were calculated. Subgroup analyses were performed based on diagnostic modality and IBD subtype. RESULTS: The overall pooled sensitivity and specificity of BUS in IBD were 90.0% and 83.5%, respectively. SICUS had the highest sensitivity (95.0%), while BUS with colour Doppler had the highest specificity (85.1%). CEUS demonstrated the highest DOR (75.52). BUS performed best in detecting postoperative CD recurrence (sensitivity 91.9%, DOR 61.9). Meta-regression identified surgical anastomosis type as a significant predictor of diagnostic performance. CONCLUSION: BUS is a highly effective noninvasive imaging modality for diagnosing and monitoring IBD. Its accuracy varies by modality, with SICUS optimal for screening and colour Doppler BUS for confirmation. Future studies should standardize BUS protocols and evaluate its role alongside MRI and CT enterography.
Source: Colorectal Disease
DOI: 10.1111/codi.70370
Institutions: University of Manchester, Dow University of Health Sciences, East Carolina University, University of Lancashire, Yeovil District Hospital NHS Foundation Trust, Yeovil District Hospital, Somerset NHS Foundation Trust, University of Central Florida, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Allama Iqbal Medical College, Universiti Sains Malaysia, University of Arkansas for Medical Sciences, Cooper University Hospital, University of Kansas
Language: English
Topic: Inflammatory Bowel Disease
Subfield: Genetics
Domain: Life Sciences
Open Access status: bronze
OpenAlex ID: W7126240367