ULTRASOUND APPEARANCES OF CROHN’S DISEASE - A PICTORIAL OVERVIEW
By Ruth Reeve, Portsmouth Hospitals University NHS Trust
Objectives:
To highlight the ultrasound characteristics of Crohn’s disease, complications in Crohn’s disease and review the role of ultrasound in the monitoring of Crohn’s disease.
Background:
Crohn’s Disease is a recurrent penetrating inflammation of the bowel wall. The entire GI tract may be affected, but the ileocaecal region is the most frequently involved. Complications of Crohn’s disease include ulceration, abscess, fistulation, fibrosis & intermittent obstruction.
Methods for monitoring Crohn’s disease include several imaging modalities, each with their own strengths and limitations. Bowel ultrasound, however, was historically unpopular, with a limited number of ultrasound practitioners skilled to perform the examination. However, the accuracy and sensitivity for identifying and characterising Crohn’s disease more recently has now led to a growing popularity and utilisation of ultrasound in managing Crohn’s disease.
Imaging Findings:
The imaging findings of Crohn’s disease vary depending on stage of disease activity and presence of complications. Key characteristics of active Crohn’s disease on ultrasound include: Wall thickening, Focal hyperechoic mesentery, Isolated thickening of the submucosal layer, Skip lesions, Poorly defined anti-mesenteric border, Increased colour Doppler pattern, Ulceration, Abscess.
Conclusion:
Ultrasound plays an important role in the management of patients presenting and being followed up for Crohn’s. This presentation demonstrates how ultrasound can identify mural & mesenteric features of ileocaecal Crohn’s disease; signs of disease activity; signs of chronicity; and identify Crohn’s complications.
