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Evidence-Based Imaging in Pediatrics pp 487–507Cite as

Imaging of Inflammatory Bowel Disease in Children

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Key Points

■ Children with clinically suspected IBD should have both upper and lower endoscopies as part of the initial workup (strong evidence). Fluoroscopic small bowel follow-through studies are typically performed as part of the initial diagnosis (limited evidence).

■ Wireless capsule endoscopy (WCE) is a safe, moderately sensitive test for the detection of small bowel inflammatory changes and should be utilized in patients without small bowel obstruction and when other diagnostic small bowel exams are negative. However, the specificity and positive predictive value need to be further established (limited evidence).

■ MRI is superior to CT and is the preferred initial diagnostic and follow-up imaging exam of perirectal and perianal disease in Crohn’s disease (CD) patients (moderate–strong evidence).

■ About 70–80% of CD patients and 30–40% of UC patients will require surgery for disease refractory to medical therapy, or severe disease with complications, or risk of malignancy (UC) (moderate evidence).

■ Repeat imaging with SBFT and CT results in significant ionizing radiation exposure and risk of later cancer induction so that alternative imaging methods, MRI and US, should be used (limited evidence).

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Author information

Authors and Affiliations

  1. Department of Radiology at the Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, 19104, Philadelphia, PA, USA

    Sudha Anupindi

  2. Department of Internal Medicine, Mount Sinai Medical Center, 10029, New York, NY, USA

    Rama Ayyala MD

  3. Department of Pediatrics, Children’s Hospital of Philadelphia, 19104, Philadelphia, PA, USA

    Judith Kelsen MD

  4. Department of Pediatrics, University of Pennsylvania School of Medicine, Children’s Hospital of Philadelphia, 19104, Philadelphia, PA, USA

    Petar Mamula MD (Director of Kohl’s Endoscopy Suite, Assistant Professor of Pediatrics)

  5. Department of Radiology, Emory University School of Medicine, 30322, Atlanta, Georgia, USA

    Kimberly E. Applegate MD, MS, FACR (Vice Chair of Quality and Safety)

Authors
  1. Sudha Anupindi
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  2. Rama Ayyala MD
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  3. Judith Kelsen MD
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  4. Petar Mamula MD
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  5. Kimberly E. Applegate MD, MS, FACR
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Editor information

Editors and Affiliations

  1. Dept. Radiology, Miami Children's Hospital, SW 114 Street 7420, Miami , 33156, U.S.A.

    L. Santiago Medina

  2. Dept. Radiology, Riley Children's Hospital, Barnhill Drive 702 , Indianapolis, 46202-5200, U.S.A.

    Kimberly E. Applegate

  3. Harborview Medical Center, University of Washington, Ninth Avenue 325, Seattle, 98104-2499, U.S.A.

    C. Craig Blackmore

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Anupindi, S., Ayyala, R., Kelsen, J., Mamula, P., Applegate, K.E. (2010). Imaging of Inflammatory Bowel Disease in Children. In: Medina, L., Applegate, K., Blackmore, C. (eds) Evidence-Based Imaging in Pediatrics. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0922-0_33

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  • DOI: https://doi.org/10.1007/978-1-4419-0922-0_33

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