Review
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World J Radiol. Jun 28, 2014; 6(6): 313-328
Published online Jun 28, 2014. doi: 10.4329/wjr.v6.i6.313
Imaging of the small bowel: Crohn’s disease in paediatric patients
Emanuele Casciani, Chiara De Vincentiis, Elisabetta Polettini, Gabriele Masselli, Giovanni Di Nardo, Fortunata Civitelli, Salvatore Cucchiara, Gian Franco Gualdi
Emanuele Casciani, Elisabetta Polettini, Gabriele Masselli, Gian Franco Gualdi, Department of Emergency Radiology, “La Sapienza” University-Hospital Umberto I, 00166 Rome, Italy
Chiara De Vincentiis, Department of Radiology, “La Sapienza” University-Sant’Andrea’s Hospital, 00189 Rome, Italy
Giovanni Di Nardo, Fortunata Civitelli, Salvatore Cucchiara, Department of Pediatrics, Gastroenterology and Liver Unit, “La Sapienza” University-Hospital Umberto I, 00166 Rome, Italy
Author contributions: Casciani E designed the study and wrote the manuscript; De Vincentiis C helped to write the manuscript; Polettini E, Masselli G, Di Nardo G, Civitelli F, Cucchiara S and Gualdi GF provided the collection of part of the material; all the authors were also involved in editing the manuscript.
Correspondence to: Dr. Emanuele Casciani, Department of Emergency Radiology, “La Sapienza” University-Hospital Umberto I, Viale del Policlinico 155, 00161 Roma, Italy. emanuelecasciani@gmail.com
Telephone: +39-06-49979465 Fax: +39-06-6630218
Received: November 27, 2013
Revised: April 14, 2014
Accepted: May 16, 2014
Published online: June 28, 2014
Abstract

In more than 20% of all patients, the Crohn’s disease presents before the age of 18years. The diagnosis and management of Crohn’s disease in children has changed dramatically over the last decade, mainly due to increased awareness, availability of newer diagnostic modalities such as magnetic resonance imaging (MRI) and newer, more powerful treatments such as biologics. Imaging of the small bowel is needed for diagnosis, management, follow-up and also evaluation of the disease in terms of location, extent, activity and complications. We review all the methods (barium examinations, ultrasonography, computed tomography, MR, and computed tomography- positron emission tomography) commonly used for imaging the small bowel in paediatric patients with Crohn’s disease analyzing the advantages and disadvantages of each modality, with particular emphasis on MR imaging.

Keywords: Barium studies, Ultrasonography, Computed tomography, Magnetic resonance, Positron emission tomography-computed tomography

Core tip: Nowadays there is a great awareness of the risks associated with the use of ionizing radiation, particularly in children. This article evaluates all the imaging methods now available for the study of Crohn's disease in pediatric patients emphasizing the magnetic resonance imaging.