Diagnostic imaging in inflammatory bowel disease in paediatric patients

Abstract

Barium radiography and endoscopy are the primary methods for evaluation of inflammatory bowel disease (IBD) in children1. These two methods arc sufficient for detection of mucosal lesions of the entire gastrointestinal tract with the exception of those parts of the small bowel which are not accessible for the endoscope. The two methods, however, cannot reliably detect extraluminal lesions and frequently cannot determine the thickness of the bowel wall. This applies to primary manifestations as well as complications of IBD, such as abscess, fistulae, perirectal disease, mesenteric disease, bone involvement, hepatobiliary complications, and complications of the urinary tract. For all these questions, the cross-sectional imaging modalities, especially ultrasound and computerized tomography, provide additional answers. These two methods are also helpful in differentiating the two main entities of inflammatory bowel disease, namely Crohn’s disease and ulcerative colitis. This is true for approximately 85% of all cases leaving out those patients with so-called indeterminate colitis.