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Radiology Redefined

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Inflammatory Bowel Disease

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Inflammatory bowel disease (IBD) affects approximately 1.4 million people in North America. Because of its tendency to present in younger patients and episodic course, patients often undergo numerous imaging studies (Gee and Harisinghani, J Magn Reson Imaging 33:527–534, 2011). Incorporating imaging into the management of these patients is important and can be challenging for clinicians. Multiple imaging studies can be employed for the diagnosis of IBD, assessment of response to therapy and disease activity, and detection of complications. These imaging studies include small bowel follow through examination, enteroclysis, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US). Over time, computed tomographic enterography (CTE) and magnetic resonance enterography (MRE) have become the modalities of choice due to their outstanding image quality, lack of need for bowel preparation, and ability to diagnose extraintestinal complications of the disease (Towbin et al., Radiographics 33:1843–1860, 2013). MRE does not utilize ionizing radiation and can employ cine imaging to evaluate peristalsis, conferring additional advantages on MRI as an imaging modality.

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References

  1. Gee MS, Harisinghani MG. MRI in patients with inflammatory bowel disease. J Magn Reson Imaging. 2011;33:527–34.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Towbin AJ, Sullivan J, Denson LA, et al. CT and MR enterography in children and adolescents with inflammatory bowel disease. Radiographics. 2013;33:1843–60.

    Article  PubMed  Google Scholar 

  3. Rogler G, Vavricka SR, Biedermann L. Integrating imaging into clinical practice in inflammatory bowel disease. Dig Dis. 2015;33(Suppl 1):37–43.

    Article  PubMed  Google Scholar 

  4. Panes J, Bouhnik Y, Reinisch W, et al. Imaging techniques for assessment of inflammatory bowel disease: joint ECCO and ESGAR evidence-based consensus guidelines. J Crohns Colitis. 2013;7:556–85.

    Article  CAS  PubMed  Google Scholar 

  5. Panes J, Bouzas R, Chaparro M, et al. Systematic review: the use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn’s disease. Aliment Pharmacol Ther. 2011;34:125–45.

    Article  CAS  PubMed  Google Scholar 

  6. Parente F, Greco S, Molteni M, et al. Role of early ultrasound in detecting inflammatory intestinal disorders and identifying their anatomical location within the bowel. Aliment Pharmacol Ther. 2003;18:1009–16.

    Article  CAS  PubMed  Google Scholar 

  7. Rimola J, Ordas I, Rodriguez S, et al. Magnetic resonance imaging for evaluation of Crohn’s disease: validation of parameters of severity and quantitative index of activity. Inflamm Bowel Dis. 2011;17:1759–68.

    Article  PubMed  Google Scholar 

  8. Rimola J, Ordas I, Rodriguez S, et al. Imaging indexes of activity and severity for Crohn’s disease: current status and future trends. Abdom Imaging. 2012;37:958–66.

    Article  PubMed  Google Scholar 

  9. Rimola J, Rodriguez S, Cabanas ML, et al. MRI of Crohn’s disease: from imaging to pathology. Abdom Imaging. 2012;37:387–96.

    Article  PubMed  Google Scholar 

  10. Dillman JR, Adler J, Zimmermann EM, et al. CT enterography of pediatric Crohn disease. Pediatr Radiol. 2010;40:97–105.

    Article  PubMed  Google Scholar 

  11. Young BM, Fletcher JG, Booya F, et al. Head-to-head comparison of oral contrast agents for cross-sectional enterography: small bowel distention, timing, and side effects. J Comput Assist Tomogr. 2008;32:32–8.

    Article  PubMed  Google Scholar 

  12. Low RN, Sebrechts CP, Politoske DA, et al. Crohn disease with endoscopic correlation: single-shot fast spin-echo and gadolinium-enhanced fat-suppressed spoiled gradient-echo MR imaging. Radiology. 2002;222:652–60.

    Article  PubMed  Google Scholar 

  13. Zappa M, Stefanescu C, Cazals-Hatem D, et al. Which magnetic resonance imaging findings accurately evaluate inflammation in small bowel Crohn’s disease? A retrospective comparison with surgical pathologic analysis. Inflamm Bowel Dis. 2011;17:984–93.

    Article  PubMed  Google Scholar 

  14. Maccioni F, Bruni A, Viscido A, et al. MR imaging in patients with Crohn disease: value of T2- versus T1-weighted gadolinium-enhanced MR sequences with use of an oral superparamagnetic contrast agent. Radiology. 2006;238:517–30.

    Article  PubMed  Google Scholar 

  15. Laghi A, Borrelli O, Paolantonio P, et al. Contrast enhanced magnetic resonance imaging of the terminal ileum in children with Crohn’s disease. Gut. 2003;52:393–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Sempere GA, Martinez Sanjuan V, Medina Chulia E, et al. MRI evaluation of inflammatory activity in Crohn’s disease. AJR Am J Roentgenol. 2005;184:1829–35.

    Article  PubMed  Google Scholar 

  17. Pupillo VA, Di Cesare E, Frieri G, et al. Assessment of inflammatory activity in Crohn’s disease by means of dynamic contrast-enhanced MRI. Radiol Med. 2007;112:798–809.

    Article  CAS  PubMed  Google Scholar 

  18. Del Vescovo R, Sansoni I, Caviglia R, et al. Dynamic contrast enhanced magnetic resonance imaging of the terminal ileum: differentiation of activity of Crohn’s disease. Abdom Imaging. 2008;33:417–24.

    Article  PubMed  Google Scholar 

  19. Knuesel PR, Kubik RA, Crook DW, et al. Assessment of dynamic contrast enhancement of the small bowel in active Crohn’s disease using 3D MR enterography. Eur J Radiol. 2010;73:607–13.

    Article  PubMed  Google Scholar 

  20. Oto A, Fan X, Mustafi D, et al. Quantitative analysis of dynamic contrast enhanced MRI for assessment of bowel inflammation in Crohn’s disease pilot study. Acad Radiol. 2009;16:1223–30.

    Article  PubMed  Google Scholar 

  21. Horsthuis K, Nederveen AJ, de Feiter MW, et al. Mapping of T1-values and gadolinium-concentrations in MRI as indicator of disease activity in luminal Crohn’s disease: a feasibility study. J Magn Reson Imaging. 2009;29:488–93.

    Article  PubMed  Google Scholar 

  22. Giusti S, Faggioni L, Neri E, et al. Dynamic MRI of the small bowel: usefulness of quantitative contrast-enhancement parameters and time-signal intensity curves for differentiating between active and inactive Crohn’s disease. Abdom Imaging. 2010;35:646–53.

    Article  PubMed  Google Scholar 

  23. Oto A, Zhu F, Kulkarni K, et al. Evaluation of diffusion-weighted MR imaging for detection of bowel inflammation in patients with Crohn’s disease. Acad Radiol. 2009;16:597–603.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Froehlich JM, Waldherr C, Stoupis C, et al. MR motility imaging in Crohn’s disease improves lesion detection compared with standard MR imaging. Eur Radiol. 2010;20:1945–51.

    Article  PubMed  Google Scholar 

  25. Punwani S, Rodriguez-Justo M, Bainbridge A, et al. Mural inflammation in Crohn disease: location-matched histologic validation of MR imaging features. Radiology. 2009;252:712–20.

    Article  PubMed  Google Scholar 

  26. Koh DM, Miao Y, Chinn RJ, et al. MR imaging evaluation of the activity of Crohn’s disease. AJR Am J Roentgenol. 2001;177:1325–32.

    Article  CAS  PubMed  Google Scholar 

  27. Masselli G, Casciani E, Polettini E, et al. Assessment of Crohn’s disease in the small bowel: prospective comparison of magnetic resonance enteroclysis with conventional enteroclysis. Eur Radiol. 2006;16:2817–27.

    Article  PubMed  Google Scholar 

  28. Fidler J. MR imaging of the small bowel. Radiol Clin N Am. 2007;45:317–31.

    Article  PubMed  Google Scholar 

  29. Kayhan A, Oommen J, Dahi F, et al. Magnetic resonance enterography in Crohn’s disease: standard and advanced techniques. World J Radiol. 2010;2:113–21.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Masselli G, Brizi GM, Parrella A, et al. Crohn disease: magnetic resonance enteroclysis. Abdom Imaging. 2004;29:326–34.

    Article  CAS  PubMed  Google Scholar 

  31. Oto A, Kayhan A, Williams JT, et al. Active Crohn’s disease in the small bowel: evaluation by diffusion weighted imaging and quantitative dynamic contrast enhanced MR imaging. J Magn Reson Imaging. 2011;33:615–24.

    Article  PubMed  Google Scholar 

  32. Fidler JL, Guimaraes L, Einstein DM. MR imaging of the small bowel. Radiographics. 2009;29:1811–25.

    Article  PubMed  Google Scholar 

  33. Tolan DJ, Greenhalgh R, Zealley IA, et al. MR enterographic manifestations of small bowel Crohn disease. Radiographics. 2010;30:367–84.

    Article  PubMed  Google Scholar 

  34. Gourtsoyianni S, Papanikolaou N, Amanakis E, et al. Crohn’s disease lymphadenopathy: MR imaging findings. Eur J Radiol. 2009;69:425–8.

    Article  PubMed  Google Scholar 

  35. Beall DP, Fortman BJ, Lawler BC, et al. Imaging bowel obstruction: a comparison between fast magnetic resonance imaging and helical computed tomography. Clin Radiol. 2002;57:719–24.

    Article  CAS  PubMed  Google Scholar 

  36. Rieber A, Aschoff A, Nussle K, et al. MRI in the diagnosis of small bowel disease: use of positive and negative oral contrast media in combination with enteroclysis. Eur Radiol. 2000;10:1377–82.

    Article  CAS  PubMed  Google Scholar 

  37. Haggett PJ, Moore NR, Shearman JD, et al. Pelvic and perineal complications of Crohn’s disease: assessment using magnetic resonance imaging. Gut. 1995;36:407–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Laniado M, Makowiec F, Dammann F, et al. Perianal complications of Crohn disease: MR imaging findings. Eur Radiol. 1997;7:1035–42.

    Article  CAS  PubMed  Google Scholar 

  39. O’Donovan AN, Somers S, Farrow R, et al. MR imaging of anorectal Crohn disease: a pictorial essay. Radiographics. 1997;17:101–7.

    Article  PubMed  Google Scholar 

  40. Schwartz DA, Wiersema MJ, Dudiak KM, et al. A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn’s perianal fistulas. Gastroenterology. 2001;121:1064–72.

    Article  CAS  PubMed  Google Scholar 

  41. Hori M, Oto A, Orrin S, et al. Diffusion-weighted MRI: a new tool for the diagnosis of fistula in ano. J Magn Reson Imaging. 2009;30:1021–6.

    Article  PubMed  Google Scholar 

  42. Sinha R, Verma R, Verma S, et al. MR enterography of Crohn disease: part 1, rationale, technique, and pitfalls. AJR Am J Roentgenol. 2011;197:76–9.

    Article  PubMed  Google Scholar 

  43. Savoye-Collet C, Savoye G, Koning E, et al. Fistulizing perianal Crohn’s disease: contrast-enhanced magnetic resonance imaging assessment at 1 year on maintenance anti-TNF-alpha therapy. Inflamm Bowel Dis. 2011;17:1751–8.

    Article  CAS  PubMed  Google Scholar 

  44. Ng SC, Plamondon S, Gupta A, et al. Prospective evaluation of anti-tumor necrosis factor therapy guided by magnetic resonance imaging for Crohn’s perineal fistulas. Am J Gastroenterol. 2009;104:2973–86.

    Article  CAS  PubMed  Google Scholar 

  45. Steward MJ, Punwani S, Proctor I, et al. Non-perforating small bowel Crohn’s disease assessed by MRI enterography: derivation and histopathological validation of an MR-based activity index. Eur J Radiol. 2012;81:2080–8.

    Article  PubMed  Google Scholar 

  46. Al-Hawary M, Zimmermann EM. A new look at Crohn’s disease: novel imaging techniques. Curr Opin Gastroenterol. 2012;28:334–40.

    PubMed  Google Scholar 

  47. Feuerbach S. MRI enterography: the future of small bowel diagnostics? Dig Dis. 2010;28:433–8.

    Article  CAS  PubMed  Google Scholar 

  48. Hafeez R, Greenhalgh R, Rajan J, et al. Use of small bowel imaging for the diagnosis and staging of Crohn’s disease–a survey of current UK practice. Br J Radiol. 2011;84:508–17.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Chalian M, Ozturk A, Oliva-Hemker M, et al. MR enterography findings of inflammatory bowel disease in pediatric patients. AJR Am J Roentgenol. 2011;196:W810–6.

    Article  PubMed  Google Scholar 

  50. Palmer L, Herfarth H, Porter CQ, et al. Diagnostic ionizing radiation exposure in a population-based sample of children with inflammatory bowel diseases. Am J Gastroenterol. 2009;104:2816–23.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Desmond AN, O’Regan K, Curran C, et al. Crohn’s disease: factors associated with exposure to high levels of diagnostic radiation. Gut. 2008;57:1524–9.

    Article  CAS  PubMed  Google Scholar 

  52. Gore RM, Balthazar EJ, Ghahremani GG, et al. CT features of ulcerative colitis and Crohn’s disease. AJR Am J Roentgenol. 1996;167:3–15.

    Article  CAS  PubMed  Google Scholar 

  53. Brenner DJ. Should computed tomography be the modality of choice for imaging Crohn’s disease in children? The radiation risk perspective. Gut. 2008;57:1489–90.

    Article  PubMed  Google Scholar 

  54. Pierce DA, Preston DL. Radiation-related cancer risks at low doses among atomic bomb survivors. Radiat Res. 2000;154:178–86.

    Article  CAS  PubMed  Google Scholar 

  55. Craig O, O’Neill S, O’Neill F, et al. Diagnostic accuracy of computed tomography using lower doses of radiation for patients with Crohn’s disease. Clin Gastroenterol Hepatol. 2012;10:886–92.

    Article  PubMed  Google Scholar 

  56. O’Neill SB, Mc Laughlin PD, Crush L, et al. A prospective feasibility study of sub-millisievert abdominopelvic CT using iterative reconstruction in Crohn’s disease. Eur Radiol. 2013;23:2503–12.

    Article  PubMed  Google Scholar 

  57. Hammer MR, Podberesky DJ, Dillman JR. Multidetector computed tomographic and magnetic resonance enterography in children: state of the art. Radiol Clin N Am. 2013;51:615–36.

    Article  PubMed  Google Scholar 

  58. Athanasakos A, Mazioti A, Economopoulos N, et al. Inflammatory bowel disease-the role of cross-sectional imaging techniques in the investigation of the small bowel. Insights Imaging. 2015;6:73–83.

    Article  PubMed  Google Scholar 

  59. Darge K, Papadopoulou F, Ntoulia A, et al. Safety of contrast-enhanced ultrasound in children for non-cardiac applications: a review by the Society for Pediatric Radiology (SPR) and the International Contrast Ultrasound Society (ICUS). Pediatr Radiol. 2013;43:1063–73.

    Article  PubMed  Google Scholar 

  60. Pallotta N, Civitelli F, Di Nardo G, et al. Small intestine contrast ultrasonography in pediatric Crohn’s disease. J Pediatr. 2013;163:778–84 e1.

    Article  PubMed  Google Scholar 

  61. Darge K, Anupindi S, Keener H, et al. Ultrasound of the bowel in children: how we do it. Pediatr Radiol. 2010;40:528–36.

    Article  PubMed  Google Scholar 

  62. Dillman JR, Stidham RW, Higgins PD, et al. US elastography-derived shear wave velocity helps distinguish acutely inflamed from fibrotic bowel in a Crohn disease animal model. Radiology. 2013;267:757–66.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, University of Chicago, Chicago, IL, USA

    Emily Ward & Aytekin Oto

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  1. Emily Ward
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  2. Aytekin Oto
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Editors and Affiliations

  1. Inflammatory Bowel Disease Center, The University of Chicago Medicine, Chicago, Illinois, USA

    Russell D. Cohen

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Ward, E., Oto, A. (2017). Radiology Redefined. In: Cohen, R. (eds) Inflammatory Bowel Disease. Clinical Gastroenterology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-53763-4_6

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  • DOI: https://doi.org/10.1007/978-3-319-53763-4_6

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  • Publisher Name: Humana Press, Cham

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