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Could a new ultrasound technique replace colonoscopy for Crohn's disease monitoring?
Colonoscopy is the current gold standard for checking whether Crohn's disease is active or in remission, but it's invasive, uncomfortable, and can't be done repeatedly. While ultrasound techniques exist, they have limitations in accurately detecting disease activity. A recent study by Wang et al. published in Insights into Imaging (2026) tested a new ultrasound technique called super-resolution contrast-enhanced ultrasound (SR-CEUS) as a potential non-invasive alternative. The technique involves injecting tiny harmless gas bubbles into the bloodstream and tracking them individually through the smallest blood vessels in the gut wall, generating detailed maps of blood flow and vessel structure. In active Crohn's disease, these vessels appear disorganised and tortuous, which is characteristic of inflammation-driven changes in the bowel wall. In a study of 52 patients, SR-CEUS performed significantly better than conventional ultrasound methods at distinguishing active from inactive disease. When combined with standard bowel ultrasound, which assesses structural changes in the bowel wall, it detected every case of active disease, suggesting this combination could be a promising non-invasive monitoring tool for Crohn's patients in the future.
Wang, Y., Ge, W., Yu, Y. et al. A novel super-resolution contrast-enhanced ultrasound approach for evaluating inflammatory activity in Crohn’s disease. Insights Imaging 17, 135 (2026). https://doi.org/10.1186/s13244-026-02309-1