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

Sep 29, 2026

Early diagnosis and treatment of inflammatory bowel disease (IBD) are crucial for preventing complications. Colonoscopy with biopsy is the gold-standard diagnosis but is invasive and costly. This study evaluates the diagnostic accuracy of bowel ultrasound (BUS) for detecting IBD, using colonoscopy with histology as the confirmatory reference. A radiologist generated preliminary IBD diagnoses from BUS parameters and compared them with histology. BUS showed strong performance, with key parameters exceeding 80% accuracy.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background and Aim

Methods

Results

Conclusion

Introduction

Journal of Clinical Ultrasound RESEARCH ARTICLE OPEN ACCESS Accuracy of Bowel Ultrasound for Detecting Inflammatory Bowel Disease at a Tertiary Hospital in Central South Africa Amanda Hendricks | Henra Muller Department of Clinical Sciences, Faculty of Health and Environmental Sciences, Central University of Technology, Bloemfontein, Free State, South Africa Correspondence: Henra Muller ([henramuller@cut.ac.za](henramuller@cut.ac.za)) Received: 18 November 2024 | Revised: 30 July 2025 | Accepted: 12 August 2025 Funding: This research was funded by a postgraduate grant from the Central University of Technology. The university provides funding for students pursuing postgraduate studies, but this grant does not have a specific allocated grant number. Keywords: bowel biopsy | bowel ultrasound | bowel ultrasound parameters | colonoscopy | Crohn's disease | inflammatory bowel disease | ulcerative colitis 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 ofIBD 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 ofIBD may facilitate the diagnosis and monitoring ofIBD. 1 | Introduction Inflammatory bowel disease (IBD) is a chronic gastrointestinal condition characterized by exacerbations that can, overtime, lead to complications such as stenosis and perforation (Wilson 2020; Furfaro et al. 2021; Windsor et al. 2023) . The exact cause of IBD remains unknown, but it is believed that it may result from a combination of immune system dysfunction, genetics, autoimmune conditions, and environmental factors (Furfaro et al. 2021; Tavakoli et al. 2021; Saoji et al. 2024) . The incidence and prevalence of IBD have increased significantly over the last decades and affect over 6 million people globally | The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of any affiliated agency of the authors and the publisher. | | --- | | This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2025 The Author(s). Journal of Clinical Ultrasound published by Wiley Periodicals LLC. | Journal of Clinical Ultrasound, 2026; 54:99–108 99 [https://doi.org/10.1002/jcu.70041](https://doi.org/10.1002/jcu.70041) (Watermeyer et al. 2020; Silangcruz et al. 2021)

FAQs

Why is early diagnosis of inflammatory bowel disease important?

Early diagnosis and treatment reduce the risk of complications such as stenosis and perforation, which can affect morbidity and mortality.

What is the reference standard used to confirm IBD in this study?

The confirmatory diagnosis uses histology from colonoscopy with biopsy, which is described as the gold standard.

How was bowel ultrasound (BUS) evaluated for diagnostic accuracy?

A radiologist made preliminary IBD diagnoses using BUS parameter measurements, then associations and accuracy were assessed by comparing preliminary diagnoses with histology.

Sep 29, 2026

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