Published online Jan 21, 2016. doi: 10.3748/wjg.v22.i3.917
Peer-review started: May 20, 2015
First decision: August 31, 2015
Revised: September 18, 2015
Accepted: November 24, 2015
Article in press: November 24, 2015
Published online: January 21, 2016
The purpose of this paper is to evaluate the role of imaging in inflammatory bowel disease (IBD), including detection of extraluminal complications and extraintestinal manifestations of IBD, assessment of disease activity and treatment response, and discrimination of inflammatory from fibrotic strictures. IBD is a chronic idiopathic disease affecting the gastrointestinal tract that is comprised of two separate, but related intestinal disorders; Crohn’s disease and ulcerative colitis. The paper discusses, in detail the pros and cons of the different IBD imaging modalities that need to be considered in order to optimize the imaging and clinical evaluation of patients with IBD. Historically, IBD evaluation of the bowel has included imaging to assess the portions of the small bowel that are inaccessible to optical endoscopic visualization. This traditionally was performed using barium fluoroscopic techniques; however, cross-sectional imaging techniques (computed tomography and magnetic resonance imaging) are being increasingly utilized for IBD evaluation because they can simultaneously assess mural and extramural IBD manifestations. Recent advances in imaging technology, that continue to improve the ability of imaging to noninvasively follow disease activity and treatment response, are also discussed. This review article summarizes the current imaging approach in inflammatory bowel disease as well as the role of emerging imaging modalities.
Core tip: This is an up-to-date review of the current approach to the imaging evaluation of inflammatory bowel disease. We have reviewed the conventional approach to the imaging of inflammatory bowel disease as well as identified some of the newer imaging modalities and algorithms that have been employed in recent years.