ArticleWorld journal of gastrointestinal pharmacology and therapeutics2026
Multimodality ultrasound in Crohn's disease strictures.
Article in World journal of gastrointestinal pharmacology and therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundStricture formation in Crohn's disease (CD) poses a significant clinical challenge, often requiring differentiation between inflammatory and fibrotic components to guide appropriate therapy.
aimTo evaluate the utility of multimodal intestinal ultrasound - including small intestine contrast ultrasonography (SICUS), contrast-enhanced ultrasound (CEUS), and ultrasound-based elastography - in detecting and characterizing CD-related small bowel strictures.
methodsA review was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. A comprehensive search of PubMed and EMBASE databases from inception to June 2025 yielded 697 records, respectively. After screening and full-text assessment, 43 studies were included. Eligible studies reported on the use of SICUS, CEUS, and elastography for detecting or phenotyping CD strictures, with comparisons to cross-sectional imaging, histopathology, endoscopy, or surgical findings.
resultsAcross heterogeneous study designs, SICUS demonstrated high sensitivity for stricture detection (typically approximately 88%-98%) with specificity that varied by cohort and criteria. Common thresholds included bowel wall thickness > 3 mm, luminal narrowing < 1 cm, and/or prestenotic dilation > 2.5 cm. CEUS effectively distinguished fibrotic from inflammatory strictures using time-intensity curve metrics: Fibrotic strictures showed reduced peak enhancement (
conclusionMultimodal intestinal ultrasound - including SICUS, CEUS, and elastography - offers a comprehensive, radiation-free framework to detect, localize, and phenotype CD strictures. While performance is promising, variability in thresholds and reference standards limits generalizability. Standardized acquisition, predefined cut-offs, and multicenter validation are priorities before widespread adoption in treatment algorithms.
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