Learning objectives
To appreciate the imaging appearances of paediatric inflammatory bowel disease on various imaging modalities,
including ultrasound,MRI and fluoroscopy,
as illustrated by cases from our tertiary referral centre.
To understand the advantages and disadvantages of each of the imaging modalities described.
To discuss the roles of different imaging modalities at various points in the disease timeline in this patient population.
Background
Inflammatory bowel disease is an umbrella term encompassing ulcerative colitis and Crohn’s disease as well as unclassified inflammatory bowel disease where features do not fit well into either category.
Both are chronic,
progressive inflammatory conditions resulting from inappropriate immune responses to gut microbial antigens in genetically susceptible individuals exposed to environmental triggers [1] (Fig. 2).
Ulcerative colitis is limited to the colon,
although there can be limited small bowel involvement with backwash ileitis.
It affects the bowel mucosa and submucosa.
Patients also have an increased...
Findings and procedure details
In this section,
we use cases from our tertiary referral centre in London (UK) to discuss the use of various imaging modalities for inflammatory bowel disease in paediatric patients.We detail from our experience the imaging appearances as well as advantages and disadvantages of each.
Modalities discussed include:
Fluoroscopy.
Ultrasound.
MR.
At diagnosis:
As previously mentioned,
imaging of the small bowel is an important part of the investigation of inflammatory bowel disease,
partly because this region is poorly accessible by endoscopy and also because small bowel...
Conclusion
Imaging plays an important role in the diagnosis of inflammatory bowel disease as well as in the investigation of acute flare,
assessment of intra and extra-luminal complications,
follow up of disease post treatment and in the identification of extra-intestinal manifestations.
In the paediatric population ionizing radiation dose and patient tolerance are important considerations.
MR imaging has largely replaced traditional fluoroscopy at diagnosis and is the main modality used during follow up.
Ultrasound however has an increasingly important role and is often a better tolerated investigation...
Personal information
Dr Vruti Dattani.
Radiology Trainee,
Royal Free Hospital,
Pond Street,
Hampstead,
London,
NW3 2QG.
Email:
[email protected]
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Rice HE,...