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Pediatric Radiology

, Volume 40, Issue 6, pp 920–926 | Cite as

Chronic inflammatory diseases of the bowel: diagnosis and follow-up

  • Guillaume Gorincour
  • Audrey Aschero
  • Catherine Desvignes
  • François Portier
  • Brigitte Bourlière-Najean
  • Alix Ruocco-Angari
  • Philippe Devred
  • Nathalie Colavolpe
  • Bertrand Roquelaure
  • Arnaud Delarue
  • Philippe PetitEmail author
Review

Abstract

Approximately one fourth of cases of inflammatory bowel disease (IBD) occur during childhood and children are more prone than their adult counterparts to have severe disease at presentation. To investigate these diseases MR imaging is no longer an emerging tool. Numerous reviews and articles have been published on this topic underlying the advances of imaging but also the complexity and the financial impact on management of such diseases. In children it seems reasonable to consider US as the first imaging examination to perform, especially when the diagnosis of IBD is unknown. However, we believe that recent and future technical progress, especially the ability of MR to display reproducible data, and the need for gold standard evaluation of new medical therapies will increase the role of MR enterography.

Keywords

Bowel Crohn disease MRI Diffusion Child Inflammatory bowel disease Children US 

References

  1. 1.
    Scherr R, Essers J, Hakonarson H et al (2009) Genetic determinants of pediatric inflammatory bowel disease: is age of onset genetically determined? Dig Dis 27:236–239CrossRefPubMedGoogle Scholar
  2. 2.
    De Hertogh G, Aerssens J, Geboes KP et al (2008) Evidence for the involvement of infectious agents in the pathogenesis of Crohn’s disease. World J Gastroenterol 14:845–852CrossRefPubMedGoogle Scholar
  3. 3.
    Sawczenko A, Sandhu BK, Logan RF et al (2001) Prospective survey of childhood inflammatory bowel disease in the British Isles. Lancet 357:1093–1094CrossRefPubMedGoogle Scholar
  4. 4.
    Horsthuis K, Stokkers PC, Stoker J (2008) Detection of inflammatory bowel disease: diagnostic performance of cross-sectional imaging modalities. Abdom Imaging 33:407–416CrossRefPubMedGoogle Scholar
  5. 5.
    Sauer CG, Kugathasan S (2009) Pediatric inflammatory bowel disease: highlighting pediatric differences in IBD. Gastroenterol Clin North Am 38:611–628CrossRefPubMedGoogle Scholar
  6. 6.
    Anupindi SA, Darge K (2009) Imaging choices in inflammatory bowel disease. Pediatr Radiol 39:S149–S152CrossRefPubMedGoogle Scholar
  7. 7.
    Hiorns MP (2008) Imaging of inflammatory bowel disease. How? Pediatr Radiol 38:S512–S517CrossRefPubMedGoogle Scholar
  8. 8.
    Dagia C, Ditchfield M, Kean M et al (2008) Imaging for Crohn disease: use of 3-T MRI in a paediatric setting. J Med Imaging Radiat Oncol 52:480–488CrossRefPubMedGoogle Scholar
  9. 9.
    van Gemert-Horsthuis K, Florie J, Hommes DW et al (2006) Feasibility of evaluating Crohn’s disease activity at 3.0 Tesla. J Magn Reson Imaging 24:340–348CrossRefPubMedGoogle Scholar
  10. 10.
    Oto A, Zhu F, Kulkarni K et al (2009) Evaluation of diffusion-weighted MR imaging for detection of bowel inflammation in patients with Crohn’s disease. Acad Radiol 16:597–603CrossRefPubMedGoogle Scholar
  11. 11.
    Godefroy C, Pilleul F, Dugougeat F et al (2005) Value of contrast-enhanced MR enterography in pediatric Crohn’s disease: preliminary study. J Radiol 86:1685–1692CrossRefPubMedGoogle Scholar
  12. 12.
    Lee SS, Kim AY, Yang SK et al (2009) Crohn disease of the small bowel: comparison of CT enterography, MR enterography, and small-bowel follow-through as diagnostic techniques. Radiology 251:751–761CrossRefPubMedGoogle Scholar
  13. 13.
    Laghi A, Borrelli O, Paolantonio P et al (2003) Contrast enhanced magnetic resonance imaging of the terminal ileum in children with Crohn’s disease. Gut 52:393–397CrossRefPubMedGoogle Scholar
  14. 14.
    Borthne AS, Abdelnoor M, Rugtveit J et al (2006) Bowel magnetic resonance imaging of pediatric patients with oral mannitol MRI compared to endoscopy and intestinal ultrasound. Eur Radiol 16:207–214CrossRefPubMedGoogle Scholar
  15. 15.
    Kiryu S, Dodanuki K, Takao H et al (2009) Free-breathing diffusion-weighted imaging for the assessment of inflammatory activity in Crohn’s disease. J Magn Reson Imaging 29:880–886CrossRefPubMedGoogle Scholar
  16. 16.
    Rimola J, Rodriguez S, Garcia-Bosch O et al (2009) Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn’s disease. Gut 58:1113–1120CrossRefPubMedGoogle Scholar
  17. 17.
    Miao YM, Koh DM, Amin Z et al (2002) Ultrasound and magnetic resonance imaging assessment of active bowel segments in Crohn’s disease. Clin Radiol 57:913–918CrossRefPubMedGoogle Scholar
  18. 18.
    Koh DM, Miao Y, Chinn RJ et al (2001) MR imaging evaluation of the activity of Crohn’s disease. AJR 177:1325–1332PubMedGoogle Scholar
  19. 19.
    Barrau V, Sverzut JM, Rodallec MH et al (2009) Diffusion weighted imaging of the gastrointestinal tract: a sequence not to be missed. Poster RSNA LL –GI 2828Google Scholar
  20. 20.
    Leyendecker JR, Bloomfeld RS, DiSantis DJ et al (2009) MR enterography in the management of patients with Crohn disease. Radiographics 29:1827–1846CrossRefPubMedGoogle Scholar
  21. 21.
    Alexopoulou E, Roma E, Loggitsi D et al (2009) Magnetic resonance imaging of the small bowel in children with idiopathic inflammatory bowel disease: evaluation of disease activity. Pediatr Radiol 39:791–797CrossRefPubMedGoogle Scholar
  22. 22.
    Wiarda BM, Kuipers EJ, Heitbrink MA et al (2006) MR enteroclysis of inflammatory small-bowel diseases. AJR 187:522–531CrossRefPubMedGoogle Scholar
  23. 23.
    Sinha R, Rajiah P, Murphy P et al (2009) Utility of high-resolution MR imaging in demonstrating transmural pathologic changes in Crohn disease. Radiographics 29:1847–1867CrossRefPubMedGoogle Scholar
  24. 24.
    Sinha R, Murphy P, Hawker P et al (2009) Role of MRI in Crohn’s disease. Clin Radiol 64:341–352CrossRefPubMedGoogle Scholar
  25. 25.
    Paolantonio P, Ferrari R, Vecchietti F et al (2009) Current status of MR imaging in the evaluation of IBD in a pediatric population of patients. Eur J Radiol 69:418–424CrossRefPubMedGoogle Scholar
  26. 26.
    Siddiki H, Fidler J (2009) MR imaging of the small bowel in Crohn’s disease. Eur J Radiol 69:409–417CrossRefPubMedGoogle Scholar
  27. 27.
    Darge K, Anupindi SA, Jaramillo D (2008) MR imaging of the bowel: pediatric applications. Magn Reson Imaging Clin N Am 16:467–478CrossRefPubMedGoogle Scholar
  28. 28.
    Oto A, Fan X, Mustafi D et al (2009) Quantitative analysis of dynamic contrast enhanced MRI for assessment of bowel inflammation in Crohn’s disease pilot study. Acad Radiol 16:1223–1230CrossRefPubMedGoogle Scholar
  29. 29.
    Gourtsoyiannis NC, Grammatikakis J, Papamastorakis G et al (2006) Imaging of small intestinal Crohn’s disease: comparison between MR enteroclysis and conventional enteroclysis. Eur Radiol 16:1915–1925CrossRefPubMedGoogle Scholar
  30. 30.
    Punwani S, Rodriguez-Justo M, Bainbridge A et al (2009) Mural inflammation in Crohn disease: location-matched histologic validation of MR imaging features. Radiology 252:712–720CrossRefPubMedGoogle Scholar
  31. 31.
    Florie J, Wasser MN, Arts-Cieslik K et al (2006) Dynamic contrast-enhanced MRI of the bowel wall for assessment of disease activity in Crohn’s disease. AJR 186:1384–1392CrossRefPubMedGoogle Scholar
  32. 32.
    Horsthuis K, Bipat S, Stokkers PC et al (2009) Magnetic resonance imaging for evaluation of disease activity in Crohn’s disease: a systematic review. Eur Radiol 19:1450–1460CrossRefPubMedGoogle Scholar
  33. 33.
    Oto A, Fan X, Mustafi D et al (2009) Quantitative analysis of dynamic contrast enhanced MRI for assessment of bowel inflammation in Crohn’s disease pilot study. Acad Radiol 16:1223–1230CrossRefPubMedGoogle Scholar
  34. 34.
    Taylor SA, Punwani S, Rodriguez-Justo M et al (2009) Mural Crohn disease: correlation of dynamic contrast-enhanced MR imaging findings with angiogenesis and inflammation at histologic examination-pilot study. Radiology 251:369–379CrossRefPubMedGoogle Scholar
  35. 35.
    Siddiki HA, Fidler JL, Fletcher JG et al (2009) Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn’s disease. AJR 193:113–121CrossRefPubMedGoogle Scholar
  36. 36.
    Darbari A, Sena L, Argani P et al (2004) Gadolinium-enhanced magnetic resonance imaging: a useful radiological tool in diagnosing pediatric IBD. Inflamm Bowel Dis 10:67–72CrossRefPubMedGoogle Scholar
  37. 37.
    Negaard A, Paulsen V, Sandvik L et al (2007) A prospective randomized comparison between two MRI studies of the small bowel in Crohn’s disease, the oral contrast method and MR enteroclysis. Eur Radiol 17:2294–2301CrossRefPubMedGoogle Scholar
  38. 38.
    Ryan ER, Heaslip IS (2008) Magnetic resonance enteroclysis compared with conventional enteroclysis and computed tomography enteroclysis: a critically appraised topic. Abdom Imaging 33:34–37CrossRefPubMedGoogle Scholar
  39. 39.
    Gaca AM, Jaffe TA, Delaney S et al (2008) Radiation doses from small-bowel follow-through and abdomen/pelvis MDCT in pediatric Crohn disease. Pediatr Radiol 38:285–291CrossRefPubMedGoogle Scholar
  40. 40.
    Brenner DJ (2008) Should computed tomography be the modality of choice for imaging Crohn’s disease in children? The radiation risk perspective. Gut 57:1489–1490CrossRefPubMedGoogle Scholar
  41. 41.
    Toma P, Granata C, Magnano G et al (2007) CT and MRI of paediatric Crohn disease. Pediatr Radiol 37:1083–1092CrossRefPubMedGoogle Scholar
  42. 42.
    Bremner AR, Pridgeon J, Fairhurst J et al (2004) Ultrasound scanning may reduce the need for barium radiology in the assessment of small-bowel Crohn’s disease. Acta Paediatr 93:479–481CrossRefPubMedGoogle Scholar
  43. 43.
    Bremner AR, Griffiths M, Argent JD et al (2006) Sonographic evaluation of inflammatory bowel disease: a prospective, blinded, comparative study. Pediatr Radiol 36:947–953CrossRefPubMedGoogle Scholar
  44. 44.
    Magnano G, Granata C, Barabino A et al (2003) Polyethylene glycol and contrast-enhanced MRI of Crohn’s disease in children: preliminary experience. Pediatr Radiol 33:385–391PubMedGoogle Scholar
  45. 45.
    Ripolles T, Martinez MJ, Paredes JM et al (2009) Crohn disease: correlation of findings at contrast-enhanced US with severity at endoscopy. Radiology 253:241–248CrossRefPubMedGoogle Scholar
  46. 46.
    Fraquelli M, Colli A, Casazza G et al (2005) Role of US in detection of Crohn disease: meta-analysis. Radiology 236:95–101CrossRefPubMedGoogle Scholar
  47. 47.
    Alison M, Kheniche A, Azoulay R et al (2007) Ultrasonography of Crohn disease in children. Pediatr Radiol 37:1071–1082CrossRefPubMedGoogle Scholar
  48. 48.
    Martinez MJ, Ripolles T, Paredes JM et al (2009) Assessment of the extension and the inflammatory activity in Crohn’s disease: comparison of ultrasound and MRI. Abdom Imaging 34:141–148CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Guillaume Gorincour
    • 1
  • Audrey Aschero
    • 1
  • Catherine Desvignes
    • 1
  • François Portier
    • 2
  • Brigitte Bourlière-Najean
    • 1
  • Alix Ruocco-Angari
    • 1
  • Philippe Devred
    • 1
  • Nathalie Colavolpe
    • 1
  • Bertrand Roquelaure
    • 3
  • Arnaud Delarue
    • 4
  • Philippe Petit
    • 1
    Email author
  1. 1.Department of Pediatric RadiologyHôpital Timone EnfantMarseille Cedex 5France
  2. 2.Hôpital Ambroise Paré13291 Marseille Cedex 6France
  3. 3.Department of Pediatric GastroenterologyHôpital Timone EnfantMarseille Cedex 5France
  4. 4.Department of Pediatric SurgeryHôpital Timone EnfantMarseille Cedex 5France

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