Imaging in Inflammatory Bowel Disease: Computed Tomography and Magnetic Resonance Enterography, Ultrasound and Enteroscopy

Transabdominal ultrasound may be an effective non-invasive method of assessing disease activity and extent inCrohn's disease. The addition of power Doppler and sonographic signal-enhancing agents may increase the accuracy ofdiagnosing intestinal complications of Crohn's disease. Endoscopic ultrasound (EUS) is an effective way to evaluate perianal disease and an EUS-directed combinedmedical-surgical approach may improve long-term healing rates. Computed tomography enterography (CTE)/enteroclysis is highly sensitive and specific for diagnosing small bowelCrohn's disease and has the added advantage of detecting extraluminal complications in 20% of patients. Concernsabout exposure to ionizing radiation are leading to dose reduction and increased awareness about judicious use of thistechnique. The operating characteristics of magnetic resonance enterography/enteroclysis are improving to the point where it is areasonable radiation-free alternative to CTE. These advanced diagnostic techniques not only improve diagnostic accuracy but also allow us to assess diseaseactivity and diagnose intestinal complications such as stricture or penetrating disease.