Abstract
Inflammatory bowel disease (IBD) is a form of chronic inflammation of the gastrointestinal tract, including two major entities: ulcerative colitis and Crohn's disease. Although intestinal imaging of IBD is well known, imaging of extraintestinal manifestations is not extensively covered. In particular, the spectrum of IBD-associated or related changes in the chest is broad and may mimic other conditions. The common embryonic origin of intestine and lungs from the foregut, autoimmunity, smoking, and bacterial translocation from the colon may all be involved in the pathogenesis of these manifestations in IBD patients. Chest involvement in IBD can present concomitant with or years after the onset of the bowel disease even postcolectomy and can affect more than one thoracic structure. The purpose of the present paper is to present the different radiological spectrum of IBD-related chest manifestations, including lung parenchyma, airways, serosal surfaces, and pulmonary vasculature. The most prevalent and distinctive pattern of respiratory involvement is large airway inflammation, followed by lung alterations. Pulmonary manifestations are mainly detected by pulmonary function tests and high-resolution computed tomography (HRCT). It is desirable that radiologists know the various radiological patterns of possible respiratory involvement in such patients, especially at HRCT. It is essential for radiologists to work in multidisciplinary teams in order to establish the correct diagnosis and treatment, which rests on corticosteroids at variance with any other form of bronchiectasis.
Highlights
Inflammatory bowel disease (IBD) is a broad term that describes miscellaneous inflammatory diseases of the gastrointestinal tract
We reviewed the different radiological patterns at high-resolution computed tomography (HRCT) related to respiratory involvement in patients with IBD
Nowadays, increasing evidence suggests that IBD and extraintestinal manifestations are not isolated diseases but may have common pathophysiological pathways
Summary
Inflammatory bowel disease (IBD) is a broad term that describes miscellaneous inflammatory diseases of the gastrointestinal tract. CD is a relapsing inflammatory disease involving any site of the gastrointestinal tract manifesting with transmural and noncontiguous lesions. Radiological imaging plays a fundamental contributory role in detection, characterization, and surveillance of IBD, thanks to computed tomography (CT) and magnetic resonance (MR). Some of the extraintestinal manifestations of IBD can be detected with imaging examinations optimized for the bowel study: these include hepatobiliary, pancreatic, and genitourinary disorders. Further radiological investigations must be warranted if an extraintestinal manifestation is suspected, and it is not possible to study it well with a bowel-targeted examination. We reviewed the different radiological patterns at high-resolution computed tomography (HRCT) related to respiratory involvement in patients with IBD. Radiologists should be aware of these potential extraintestinal alterations and collaborate with clinicians and reach an accurate diagnosis
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