Imaging Modalities in Inflammatory Bowel Disease

CT and 99m Tc-WBC vs colonoscopy in the evaluation of inflammation and complications of inflammatory bowel diseases

“…In those series, abscesses were reported in 25%-59% of patients, 26,27 abnormal wall thickening in 82%-100%, 26 mesenteric abnormalities in 39%-72%, 26 fistulae in 33%, 14 abnormalities in the perirectal or perianal region in 40%-82%, 3 abnormal terminal ileum in 80%, 3 and backwash ileitis in 15%-20% of patients with UC. 2 This high incidence of complications or signs of advanced disease is discordant with our experience. Over half of the 103 CT scans we reviewed were normal.…”

“…CT is recommended by some 1 as an important tool in the evaluation of patients with suspected colonic inflammation. CT is also believed to be important in the diagnosis and management of inflammatory bowel diseases (IBD) in patients presenting with acute symptoms, 2 as a management tool in the evaluation of patients with known IBD, 3 presenting with exacerbation of their disease, 2,4 and as an essential diagnostic tool in the acutely ill patient with Crohn's disease (CD). 5,6 Finally, CT has been recommended as an initial imaging study in children with known CD and a changing pattern of clinical symptoms.…”

Particularities of Crohn’s disease in pediatric patients: current status and perspectives regarding imaging modalities

“…A close collaboration between clinicians and radiologists is mandatory in order to choose the most appropriate imaging technique and avoid unnecessary exposure to ionizing radiation [164]. In a meta-analysis including 33 articles, Horsthuis et al showed a lower sensitivity of MRI imaging in children as compared with adults (p = 0.042), but a higher specificity in pediatric patients (p = 0.024).…”

Radiation exposure during nasojejunal intubation for MRI enteroclysis

“…Previously, imaging of small bowel in patients with suspected or known Crohn's disease (CD) was based on x-ray examinations, most commonly barium small bowel follow-through or barium small bowel enteroclysis. In some countries, these are still the most commonly used modalities when investigating possible or known CD in small bowel [2,3]. Computer tomography (CT) enterography is excellent in evaluating mucosal changes in the small bowel with better sensitivity than barium studies.…”