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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2016; 22(3): 917-932
Published online Jan 21, 2016. doi: 10.3748/wjg.v22.i3.917
Inflammatory bowel disease imaging: Current practice and future directions
Aoife Kilcoyne, Jess L Kaplan, Michael S Gee
Aoife Kilcoyne, Michael S Gee, Department of Radiology, Massachusetts General Hospital, Boston, MA 02214, United States
Jess L Kaplan, Department of Pediatrics, Massachusetts General Hospital, Boston, MA 02214, United States
Author contributions: Kilcoyne A, Kaplan JL and Gee MS contributed equally to this work; Kilcoyne A, Kaplan JL and Gee MS performed the literature search, prepared, reviewed and edited the manuscript.
Conflict-of-interest statement: The authors have no conflict of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Aoife Kilcoyne, MD, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02214, United States.
Telephone: +1-617-7268396 Fax: +1-617-7264891
Received: May 17, 2015
Peer-review started: May 20, 2015
First decision: August 31, 2015
Revised: September 18, 2015
Accepted: November 24, 2015
Article in press: November 24, 2015
Published online: January 21, 2016

The purpose of this paper is to evaluate the role of imaging in inflammatory bowel disease (IBD), including detection of extraluminal complications and extraintestinal manifestations of IBD, assessment of disease activity and treatment response, and discrimination of inflammatory from fibrotic strictures. IBD is a chronic idiopathic disease affecting the gastrointestinal tract that is comprised of two separate, but related intestinal disorders; Crohn’s disease and ulcerative colitis. The paper discusses, in detail the pros and cons of the different IBD imaging modalities that need to be considered in order to optimize the imaging and clinical evaluation of patients with IBD. Historically, IBD evaluation of the bowel has included imaging to assess the portions of the small bowel that are inaccessible to optical endoscopic visualization. This traditionally was performed using barium fluoroscopic techniques; however, cross-sectional imaging techniques (computed tomography and magnetic resonance imaging) are being increasingly utilized for IBD evaluation because they can simultaneously assess mural and extramural IBD manifestations. Recent advances in imaging technology, that continue to improve the ability of imaging to noninvasively follow disease activity and treatment response, are also discussed. This review article summarizes the current imaging approach in inflammatory bowel disease as well as the role of emerging imaging modalities.

Keywords: Imaging, Inflammatory bowel disease, Crohn’s disease, Ulcerative colitis, Computed tomography, Magnetic resonance imaging

Core tip: This is an up-to-date review of the current approach to the imaging evaluation of inflammatory bowel disease. We have reviewed the conventional approach to the imaging of inflammatory bowel disease as well as identified some of the newer imaging modalities and algorithms that have been employed in recent years.