New Imaging Modalities in Inflammatory Bowel Disease

Imaging studies play a critical role in the diagnosis and evaluation of patients with known or suspected inflammatory bowel disease. Historically, conventional barium small-bowel follow-through or enteroclysis was used in the evaluation of suspected or newly diagnosed IBD. However, they continue to have a declining role, supplanted by more revealing and sensitive cross-sectional imaging techniques. Computed tomography enterography and magnetic resonance enterography are currently the primary modalities for imaging luminal as well as extraluminal disease. Ultrasound with Doppler evaluation is widely used in some centers. Positron emission tomography scanning is currently an investigative tool in IBD. These modalities are of value in establishing the diagnosis, assessing the extent, activity, and severity of disease, monitoring therapeutic response, and identifying complications, which may require change in therapy or surgical intervention. This chapter will review examination techniques and diagnostic findings, performance and limitations of each modality, and highlight their utility in clinical practice.