Detection of inflammatory bowel disease: diagnostic performance of cross-sectional imaging modalities

Abstract

Different cross-sectional imaging techniques can be used as a diagnostic tool for the evaluation of inflammatory bowel disease (IBD). In this report the diagnostic performances of ultrasonography, magnetic resonance imaging and computed tomography in the detection of IBD and the evaluation of known IBD are described, together with a short update on patient preparation and imaging technique of the respective modalities discussed.

Fig. 1.

VCE image of a 14-year-old male patient with known CD. VCE was performed as small-bowel disease was suspected. Image shows severe inflammation of the small bowel with a stenosis.

Fig. 2.

A 14-year female patient with known CD and intermittent abdominal pain. US image shows the thickened wall of the terminal ileum (arrowheads) with some infiltration of the perivisceral fat.

Fig. 3.

A 25-year-old female patient with known CD of the terminal ileum. A US image shows a large abscess (arrowheads) that was located ventrally and cranially of the bladder. B US image shows a fistula (arrowheads) that originated from the abscess.

Fig. 4.

A 60-year old female patient who underwent CT enterography for suspected bowel obstruction. Just 1 month earlier at ileocolonoscopy CD of the terminal ileum was discovered; the terminal ileum was not intubated because of the stenosis. Axial image shows the severely thickened bowel wall of the ileum (arrowheads) with only a pinpoint bowel lumen remaining.

Fig. 5.

A 25-year-old female patient with known CD of the terminal ileum (same patient as pictured in Fig. 3). A CT-scan was performed to determine involvement of the small bowel. A Coronal image shows the abscess (arrowheads). B Axial image again shows the abscess again (arrowheads). C Coronal image shows the fistula (arrowhead).

Fig. 6.

A A 38-year-old female with complaints of vomiting and an iron-deficiency anemia who was suspected of CD and underwent MRI-enteroclysis to evaluate the small bowel. Coronal TrueFISP image shows good distention of jejunal bowel loops after controlled infusion of contrast medium. B A 12-year-old male patient with known CD who underwent MR enterography for the evaluation of the small bowel. Coronal TrueFISP image shows good distention of jejunal bowel loops after oral administration of contrast medium.

Fig. 7.

A 18-year-old female patient with known CD. MRI-enterography was performed for suspicion of active CD of the neoterminal ileum. A Coronal TrueFISp image shows enlarged mesenteric lymph nodes (arrowheads). B Coronal TrueFISP image shows thickened bowel wall of the neoterminal ileum (arrowheads).

Fig. 8.

A 12-year-old male patient with known CD who underwent MR-enterography for the evaluation of the small bowel (same patient depicted in Fig. 6b). Axial T1-weighted image shows pathological enhancement of thickened small-bowel loops after administration of intravenous contrast medium (arrowheads). Approximately, 1 m of small bowel (terminal jejunum, proximal ileum) was shown to be affected.

Fig. 9.

A 25-year-old female patient with known CD of the terminal ileum (same patient as pictured in Figs. 3 and 5). A Coronal T1-weighted image clearly shows the abscess (arrowheads) that was also depicted on US and CT. B Coronal T1-weighted image showing a fistula