Diagnostic Accuracy of Intestinal Ultrasound for Detecting Postoperative Recurrence in Crohn’s Disease: A Systematic Review

This systematic review and meta-analysis evaluated the diagnostic performance of intestinal ultrasound (IUS) for detecting postoperative recurrence (POR) in Crohn's disease (CD) using ileocolonoscopy as the reference standard. A comprehensive search of major databases identified 12 prospective cohort studies, including 730 patients who underwent ileocolonic or ileocecal resection. Pooled analysis demonstrated that IUS has high diagnostic accuracy, with a sensitivity of 0.87 (95% CI: 0.78-0.93), a specificity of 0.87 (95% CI: 0.77-0.93), and an overall area under the curve of 0.91, indicating strong discriminative ability. The diagnostic odds ratio was 33.91, further supporting good test performance. Sensitivity analyses confirmed the robustness of these findings, although substantial heterogeneity was observed, particularly for sensitivity. Despite variability in IUS definitions and moderate-to-serious risk of bias across studies, the results consistently showed good correlation with endoscopic findings. Potential publication bias was detected for sensitivity but not specificity. Overall, IUS appears to be a reliable, noninvasive tool for detecting POR in CD and may help reduce reliance on routine ileocolonoscopy. However, operator dependence and methodological heterogeneity should be considered when interpreting its clinical utility.