Up-to-date overview of imaging techniques in the diagnosis and management of inflammatory bowel diseases

Abstract

Radiological examination occupies a significant role, complementary to endoscopic studies, in the diagnostic process of inflammatory bowel disease (IBD). Both ulcerative colitis and Crohn’s disease, due to multiple remissions and relapses, require repetitive examinations to evaluate the disease extent, severity, and response to pharmacological treatment. Whereas the use of barium contrast studies is progressively reduced, plain radiography confirms its utility as a first-line imaging tool for acute abdomen. Computed tomography remains an easily accessible and effective method to demonstrate disease activity and extraintestinal manifestations. However, the related radiation exposure reduces its applicability to urgent situations. Ultrasound and magnetic resonance, with the great advantage of avoiding ionising radiation, are highly recommended to present the complications of IBD. Use of oral and intravenous contrast in computed tomography enterography and magnetic resonance enterography demonstrates IBD involvement in the small intestine wall, which is difficult to assess in other radiological and endoscopic examinations.

Ultrasound as First Line Step in Anaemia Diagnostics

“…The assessment of the disease activity and the precise overview of Crohn’s extraluminal complications is beyond the scope of conventional abdomen ultrasound. Contrast-enhanced magnetic resonance enterography is the method of choice 29,30. The use of colour Doppler, contrast ultrasound and elastography increases the accuracy of the conventional ultrasound, when magnetic resonance is not available 31.…”

“…Contrast-enhanced magnetic resonance enterography is the method of choice 29,30. The use of colour Doppler, contrast ultrasound and elastography increases the accuracy of the conventional ultrasound, when magnetic resonance is not available 31. In particular, Doppler ultrasound may show bowel wall increased vascularisation due to inflammation.…”

“…29,30 The use of colour Doppler, contrast ultrasound and elastography increases the accuracy of the conventional ultrasound, when magnetic resonance is not available. 31 In particular, Doppler ultrasound may show bowel wall increased vascularisation due to inflammation. Elastography techniques, such as strain and shear wave elastography, have shown promising results, because of their ability to differentiate active inflammation from fibrosis.…”

Bone Metabolism Alteration in Patients with Inflammatory Bowel Disease

“…Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn’s disease (CD), is a group of chronic, autoimmunological diseases of the gastrointestinal tract with a diverse clinical, endoscopic, and radiological image [ 1 , 2 ]. Following a western lifestyle, such as consuming highly processed foods, engaging in little physical activity, or altering the gut microbiome with frequent antibiotic usage, may contribute to the rising incidence of IBD, especially in those who are genetically susceptible [ 3 , 4 ].…”

The role of Trans-abdominal Ultrasound in Assessing Disease Activity and Severity in Ulcerative Colitis

“…Oral administration of agents such as polyethylene glycol may improve image quality and diagnostic accuracy [7] . BUS for IBD often requires high frequency [5][6][7][8][9][10][11][12][13][14][15][16][17] linear array probes to increase the resolution and to allow adequate assessment of the intestinal wall [8] . Doppler assessment provides additional vascular information and may assist in differentiating predominantly inflammatory from fibrostenotic lesions.…”