Download PDF
Endoskopie heute 2011; 24(4): 210-215
DOI: 10.1055/s-0031-1283849
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Moderne Bildgebung bei CED

Up-to-date Imaging for IBD
A. G. Schreyer
Institut für Röntgendiagnostik, Universitätsklinikum Regensburg
,
E. M. Jung
Institut für Röntgendiagnostik, Universitätsklinikum Regensburg
,
C. Stroszczynski
Institut für Röntgendiagnostik, Universitätsklinikum Regensburg
› Author Affiliations
Further Information

Publication History

Publication Date:
21 December 2011 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Durch die ständige Weiterentwicklung der Computertomografie (CT) und der MRT, aber auch durch die Einführung neuer Verfahren wie die kontrastgestützte hochauflösende Sonografie, haben sich zusammen mit den Updates der S3-Leitlinien zur Diagnostik und Therapie bei chronisch entzündlichen Darmerkrankungen viele Änderungen bezüglich der Anwendung radiologischer Verfahren ergeben. In dem Übersichtsartikel soll basierend auf aktueller Literatur und Leitlinien ein kritischer Überblick der Verfahren bei Morbus Crohn und Colitis ulcerosa erfolgen. Ergänzt wird diese Übersicht durch Ausblicke neuer experimenteller bildgebender Verfahren, wie etwa der Diffusionsbildgebung in der MRT bei Darmerkrankungen.

Abstract

Because of the steady evolution of radiological imaging equipment, especially for CT and MR imaging, enriched by new ultrasound methods such as contrast enhanced high resolution ultrasound, several changes for radiological imaging in IBD came up. Additionally updated S3 guidelines recommend some new imaging approaches. In this review article a critical overview of radiological imaging in Crohn’s diseases as well as in ulcerative colitis is presented. Moreover recently introduced, more experimental imaging techniques such as diffusions weighted MR imaging is critically discussed.

Schlüsselwörter

MRT - CT - Sonografie - Bildgebung - chronisch entzündliche Darmerkrankungen

Key words

MRI - CT - ultrasound - imaging - IBD
 

  • Literatur

  • 1 Hoffmann JC, Autschbach F, Bokemeyer B et al. Short version of the updated German S3 (level 3) guideline on diagnosis and treatment of Crohn’s disease. Deutsche medizinische Wochenschrift (1946) 2008; 133: 1924-1929
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Schreyer AG, Ludwig D, Koletzko S et al. Updated German S3-guideline regarding the diagnosis of Crohn’s disease  – implementation of radiological modalities. Rofo 2010; 182: 116-121
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Mowat C, Cole A, Windsor A et al. Guidelines for the management of inflammatory bowel disease in adults. Gut 2011; 60: 571-607
    CrossrefPubMedGoogle Scholar
  • 4 Desmond AN, O’Regan K, Curran C et al. Crohn’s disease: factors associated with exposure to high levels of diagnostic radiation. Gu 2008; 57: 1524-1529
    PubMedGoogle Scholar
  • 5 Ott DJ, Chen YM, Gelfand DW et al. Detailed per-oral small bowel examination vs. enteroclysis. Part II: Radiographic accuracy. Radiology 1985; 155: 31-34
    PubMedGoogle Scholar
  • 6 Toms AP, Barltrop A, Freeman AH. A prospective randomised study comparing enteroclysis with small bowel follow-through examinations in 244 patients. European radiology 2001; 11: 1155-1160
    CrossrefPubMedGoogle Scholar
  • 7 Kelvin FM, Maglinte DD. Enteroclysis or small bowel follow-through in Crohn’s diseases?. Gastroenterology 1998; 114: 1349-1351
    PubMedGoogle Scholar
  • 8 Sellink JL. Radiologic examination of the small intestine by duodenal intubation. Acta Radiol 1974; 15: 318-332
    PubMedGoogle Scholar
  • 9 Schreyer AG, Menzel C, Friedrich C et al. Comparison of high-resolution ultrasound and MR-enterography in patients with inflammatory bowel disease. World Journal of Gastroenterology WJG 2011; 17: 1018-1025
    PubMedGoogle Scholar
  • 10 Schreyer AG, Finkenzeller T, Gossmann H et al. Microcirculation and perfusion with contrast enhanced ultrasound (CEUS) in Crohn’s disease: first results with linear contrast harmonic imaging (CHI). Clin Hemorheol Microcirc 2008; 40: 143-155
    PubMedGoogle Scholar
  • 11 Girlich C, Schacherer D, Lamby P et al. Innovations in contrast enhanced high resolution ultrasound improve sonographic imaging of the intestine. Clinical Hemorheology and Microcirculation 2010; 45: 207-215
    PubMedGoogle Scholar
  • 12 Jung EM, Schreyer AG, Schacherer D et al. New real-time image fusion technique for characterization of tumor vascularisation and tumor perfusion of liver tumors with contrast-enhanced ultrasound, spiral CT or MRI: first results. Clin Hemorheol Microcirc 2009; 43: 57-69
    PubMedGoogle Scholar
  • 13 Rubesin SE, Levine MS, Laufer I et al. Double-contrast barium enema examination technique. Radiology 2000; 215: 642-650
    PubMedGoogle Scholar
  • 14 Schreyer AG, Seitz J, Feuerbach S et al. Modern imaging using computer tomography and magnetic resonance imaging for inflammatory bowel disease (IBD). Inflammatory Bowel Diseases 2004; 10: 45-54
    CrossrefPubMedGoogle Scholar
  • 15 Schreyer AG, Herfarth H, Kikinis R et al. 3D modeling and virtual endoscopy of the small bowel based on magnetic resonance imaging in patients with inflammatory bowel disease. Investigative Radiology 2002; 37: 528-533
    CrossrefPubMedGoogle Scholar
  • 16 Schreyer AG, Scheibl K, Heiss P et al. MR colonography in inflammatory bowel disease. Abdom Imaging 2006; 31: 302-307
    CrossrefPubMedGoogle Scholar
  • 17 Siddiki HA, Fidler JL, Fletcher JG et al. Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn’s disease. AJR 2009; 193: 113-121
    CrossrefPubMedGoogle Scholar
  • 18 Horsthuis K, Bipat S, Bennink RJ et al. Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: meta-analysis of prospective studies. Radiology 2008; 247: 64-79
    CrossrefPubMedGoogle Scholar
  • 19 Choi D, Jin LeeS, Ah ChoY et al. Bowel wall thickening in patients with Crohn’s disease: CT patterns and correlation with inflammatory activity. Clinical Radiology 2003; 58: 68-74
    CrossrefPubMedGoogle Scholar
  • 20 Booya F, Fletcher JG, Huprich JE et al. Active Crohn disease: CT findings and interobserver agreement for enteric phase CT enterography. Radiology 2006; 241: 787-795
    CrossrefPubMedGoogle Scholar
  • 21 Madureira AJ. The comb sign. Radiology 2004; 230: 783-784
    CrossrefPubMedGoogle Scholar
  • 22 Jaffe TA, Gaca AM, Delaney S et al. Radiation doses from small-bowel follow-through and abdominopelvic MDCT in Crohn’s disease. AJR 2007; 189: 1015-1022
    CrossrefPubMedGoogle Scholar
  • 23 Wold PB, Fletcher JG, Johnson CD et al. Assessment of small bowel Crohn disease: noninvasive peroral CT enterography compared with other imaging methods and endoscopy  – feasibility study. Radiology 2003; 229: 275-281
    CrossrefPubMedGoogle Scholar
  • 24 Schreyer AG, Geissler A, Albrich H et al. Abdominal MRI after enteroclysis or with oral contrast in patients with suspected or proven Crohn’s disease. Clin Gastroenterol Hepatol 2004; 2: 491-497
    CrossrefPubMedGoogle Scholar
  • 25 Low RN, Francis IR, Politoske D et al. Crohn’s disease evaluation: comparison of contrast-enhanced MR imaging and single-phase helical CT scanning. J Magn Reson Imaging 2000; 11: 127-135
    CrossrefPubMedGoogle Scholar
  • 26 Schwartz DA, Loftus Jr EV, Tremaine WJ et al. The natural history of fistulizing Crohn’s disease in Olmsted County, Minnesota. Gastroenterology 2002; 122: 875-880
    CrossrefPubMedGoogle Scholar
  • 27 Parks AG, Gordon PH, Hardcastle JD. A classification of fistula-in-ano. The British Journal of Surgery 1976; 63: 1-12
    CrossrefPubMedGoogle Scholar
  • 28 Marks CG, Ritchie JK. Anal fistulas at St Mark’s Hospital. The British Journal of Surgery 1977; 64: 84-91
    CrossrefPubMedGoogle Scholar
  • 29 Schwartz DA, Wiersema MJ, Dudiak KM et al. A comparison of endoscopic ultrasound, magnetic resonance imaging, and exam under anesthesia for evaluation of Crohn’s perianal fistulas. Gastroenterology 2001; 121: 1064-1072
    CrossrefPubMedGoogle Scholar
  • 30 Kiryu S, Dodanuki K, Takao H et al. Free-breathing diffusion-weighted imaging for the assessment of inflammatory activity in Crohn’s disease. Journal of Magnetic Resonance Imaging JMRI 2009; 29: 880-886
    CrossrefPubMedGoogle Scholar
  • 31 Oussalah A, Laurent V, Bruot O et al. Diffusion-weighted magnetic resonance without bowel preparation for detecting colonic inflammation in inflammatory bowel disease. Gut 2010; 59: 1056-1065
    CrossrefPubMedGoogle Scholar