{
  "abstract": "The use of intestinal ultrasound (IUS) has grown rapidly as a vital tool for diagnosing and monitoring inflammatory bowel disease (IBD). 1 While paediatric data on IUS is emerging, evidence is limited and primarily from individual centres.2This study aimed to evaluate the sensitivity, specificity, and overall accuracy of IUS in diagnosing IBD in children. Secondary objectives included assessing the role of IUS in: (1) to help determine the indication for upper and lower gastrointestinal (GI) endoscopy in suspected IBD cases; and (2) ruling out the need for endoscopy in symptomatic patients with suspected gut-brain interaction disorders (DGBI).A retrospective analysis was conducted at our tertiary paediatric gastroenterology centre, including all patients who underwent IUS between September 2022 to September 2024. Patients were identified via electronic procedure lists from Radiology Department. IUS examinations were performed by three GI radiologists trained in adult and paediatric ultrasound, with two paediatric radiologists. Data were collected and analysed using Microsoft Excel.A total of 69 children were included of which 51 (73%) were males with a mean age of 12 ± 3.2 years. Diagnoses included Crohn’s disease (CD) in 31 (44%), ulcerative colitis (UC) in 18 (26%), DGBI in 18 (26%), and infective entero-colitis in 2 cases. The most common presenting symptoms were abdominal pain in 56 (81%), loose stools in 47(68%), and increased bowel movements in 36 (52%)Clinical impression correlated with IUS findings in 84% (58/69) of the cases, and with endoscopic findings in 91% (63/69). In 76% (53/69), IUS and endoscopy findings aligned with clinical impression. As shown in table 1, IUS demonstrated a sensitivity of 88%, positive predictive value (PPV) of 89%, specificity of 73%, negative predictive value (NPV) of 70%, and overall accuracy of 84%. Notably, all six false negatives, where IUS did not detect the final diagnosis confirmed clinically and endoscopically, involved UC proctitis or distal colitis, with IUS performed 3–6 months after treatment initiation. Additionally, in two CD cases, disease was detected solely by IUS, as the lesions involved small bowel segments inaccessible to endoscopy. In 8 patients, IUS suggested nodular lymphoid hyperplasia (NLH), with endoscopic confirmation in 5. Only 1 patient underwent magnetic resonance enterography (MRE), which showed a longer diseased segment than measured by IUS.Advances in technology and operator expertise position IUS as a valuable, non-invasive, baseline modality for children with suspected IBD. Its accuracy approaches that of more traditional imaging like MRE, with reduced cost and improved patient comfort. Limitations include operator dependence, patient body habitus, disease location, and timing relative to treatment initiation. Skilled IUS-trained practitioners can reduce reliance on MRE, optimising resource use and patient satisfaction.References Kellar A, Dolinger M, Novak K, et al. Intestinal ultrasound for the pediatric gastroenterologist: a guide for inflammatory bowel disease monitoring in children. expert consensus on behalf of the international bowel ultrasound group (IBUS) pediatric committee. JPGN 2023;76(2).Green Z, Towriss C, Ashton JJ, et al. Noninvasive monitoring with bowel ultrasound (NIMBUS) in paediatric inflammatory bowel disease: feasibility in a single centre. J Pediatr Gastroenterol Nutr 2025 Jul 21. doi: 10.1002/jpn3.70159.Abstract OC48 Table 1Parameters defining accuracy of IUS in detecting IBD, benchmarked against clinical and endoscopic criteriaFNn=6FPn=5TPn=44SensitivityTP/ (TP+FN)88%PPVTP/(TP+FP)89.8%TNn=14NPVTN/(TN+FN)70%SpecificityTN/(TN+FP)73.7%Accuracy84%TP: true positive, TN: true negative, FP: false positive, FN: false negative, PPV: positive predictive value, NPV: negative predictive value",
  "authors": [
    {
      "affiliations": [
        "Norfolk and Norwich University Hospital"
      ],
      "name": "Prarthana Kalgaonkar"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospital"
      ],
      "name": "Krishna Alkanti"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospital"
      ],
      "name": "Hameed Rafiee"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospital"
      ],
      "name": "Matthew Kim"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospital"
      ],
      "name": "Clare Price"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospital"
      ],
      "name": "Liam Ward"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospital"
      ],
      "name": "Sana Sheykhzadeh"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospital"
      ],
      "name": "Eleanor Goodale"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospital"
      ],
      "name": "Mary-anne Morris"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospital"
      ],
      "name": "Ghada Said"
    },
    {
      "affiliations": [
        "UEA"
      ],
      "name": "Shafi Jazim"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospital"
      ],
      "name": "Sue Underhill-smith"
    },
    {
      "affiliations": [
        "Norfolk and Norwich University Hospital"
      ],
      "name": "Marco Gasparetto"
    }
  ],
  "title": "OC48 Intestinal ultrasound (IUS): a ‘new’ old friend and vital tool in diagnosing inflammatory bowel disease (IBD) in children",
  "uid": "2f39e234-60f1-5760-8df6-705f8ce0d0df"
}