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World J Gastroenterol. Jun 28, 2007; 13(24): 3279-3287
Published online Jun 28, 2007. doi: 10.3748/wjg.v13.i24.3279
Imaging of the small bowel in Crohn's disease: A review of old and new techniques
Simone Saibeni, Emanuele Rondonotti, Andrea Iozzelli, Luisa Spina, Gian Eugenio Tontini, Flaminia Cavallaro, Camilla Ciscato, Roberto de Franchis, Francesco Sardanelli, Maurizio Vecchi
Simone Saibeni, Emanuele Rondonotti, Roberto de Franchis, Gastroenterology and Gastrointestinal Endoscopy Service, IRCCS Fondazione Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena, Milan, Italy
Andrea Iozzelli, Francesco Sardanelli, Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, University of Milan School of Medicine, Milan, Italy
Luisa Spina, Gian Eugenio Tontini, Flaminia Cavallaro, Camilla Ciscato, Maurizio Vecchi, Gastroenterology and Gastrointestinal Endoscopy Unit, University of Milan School of Medicine, Milan, Italy
Simone Saibeni, Emanuele Rondonotti, Roberto de Franchis, Luisa Spina, Gian Eugenio Tontini, Flaminia Cavallaro, Camilla Ciscato, Maurizio Vecchi, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS Policlinico San Donato, University of Milan School of Medicine, Milan, Italy
Andrea Iozzelli, Francesco Sardanelli, Departments of Medical and Surgical Sciences, University of Milan School of Medicine, Milan, Italy
Author contributions: All authors contributed equally to the work.
Correspondence to: Maurizio Vecchi, Professor, Gastro-enterology and Gastrointestinal Endoscopy Unit IRCCS Policlinico San Donato, Via Morandi 30 20097 San Donato Milanese, Milan, Italy. maurizio.vecchi@unimi.it
Telephone: +39-2-52774652 Fax: +39-2-52774655
Received: January 19, 2007
Revised: February 3, 2007
Accepted: February 8, 2007
Published online: June 28, 2007
Abstract

The investigation of small bowel morphology is often mandatory in many patients with Crohn’s disease. Traditional radiological techniques (small bowel enteroclysis and small bowel follow-through) have long been the only suitable methods for this purpose. In recent years, several alternative imaging techniques have been proposed. To review the most recent advances in imaging studies of the small bowel, with particular reference to their possible application in Crohn’s disease, we conducted a complete review of the most important studies in which traditional and newer imaging methods were performed and compared in patients with Crohn’s disease. Several radiological and endoscopic techniques are now available for the study of the small bowel; each of them is characterized by a distinct profile of favourable and unfavourable features. In some cases, they may also be used as complementary rather than alternative techniques. In everyday practice, the choice of the technique to be used stands upon its availability and a careful evaluation of diagnostic accuracy, clinical usefulness, safety and cost. The recent development of innovative imaging techniques has opened a new and exciting area in the exploration of the small bowel in Crohn’s disease patients.

Keywords: Crohn’s disease; Small bowel; Imaging techniques; Ultrasonography; Magnetic resonance; Computed tomography; Video-capsule endoscopy; Double-balloon endoscopy