Skip to main content
SpringerLink
Log in

Current Status of Imaging in Small and Large Bowel Diseases

  • Chapter
  • First Online:
Crohn’s Disease

  • 1290 Accesses

Abstract

Over the years, radiological examinations for small and large bowel are radically changed: milestones were the introduction of barium meals in the 1950s, of enteroclysis in the 1980s, and of cross-sectional techniques in the 1990s.

Until the 1980s, gold standard examinations were the small bowel follow-through (SBFT) and the single-contrast colon enema. In the 1980s, Sellink JL, Herlinger H, and Maglinte DD developed single- and double-contrast small bowel enteroclysis, while Welin S, Altaras J, and Cittadini G encoded the method of the double-contrast barium enema of the colon. These examinations provide an extraordinary evaluation of the mucosal layer with a reported sensitivity and a specificity respectively of 85–95 % and 89–94 % in the detection of the typical Crohn’s disease lesions, when performed by expert radiologists. Unfortunately, they give only indirect information on transmural and extraintestinal involvement, with difficulties in the assessment of single bowel loops, even if displayed in transparency.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Gasche C, Schober E, Turetschek K. Small bowel barium studies in Crohn’s disease. Gastroenterology. 1998;114(6):1349.

    Article  CAS  PubMed  Google Scholar 

  2. ROBINSON JM. Detection of small lesions of the large bowel; barium enema versus double contrast. Calif Med. 1954;81(5):321–4.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Sellink JL. Radiologic examination of the small intestine by duodenal intubation. Acta Radiol Diagn (Stockh). 1974;15(3):318–32.

    CAS  Google Scholar 

  4. Rubesin SE, Levine MS, Laufer I, Herlinger H. Double-contrast barium enema examination technique. Radiology. 2000;215(3):642–50.

    Article  CAS  PubMed  Google Scholar 

  5. Rubesin SE, Maglinte DD. Double-contrast barium enema technique. Radiol Clin North Am. 2003;41(2):365–76.

    Article  PubMed  Google Scholar 

  6. Welin S, Welin G. The double contrast examination of the colon. Experience with the Welin modification. Stuttgart: Georg Thieme Publishers; 1976. p. 110–1.

    Google Scholar 

  7. Altaras J. Radiologischer Atlas. Kolon und Rektum. Munchen: Urban & Schwarzenberg; 1982.

    Google Scholar 

  8. Cittadini G. Double contrast barium enema: the Genoa approach. Milan: Springer; 1998.

    Book  Google Scholar 

  9. Paparo F, Denegri A, Revelli M, Puppo C, Garello I, Bacigalupo L, Garlaschi A, Rollandi L, Fornaro R. Crohn’s disease: value of diagnostic imaging in the evaluation of anastomotic recurrence. Ann Ital Chir. 2014;85(3):271–81.

    PubMed  Google Scholar 

  10. Algin O, Evrimler S, Arslan H. Advances in radiologic evaluation of small bowel diseases. J Comput Assist Tomogr. 2013;37(6):862–71.

    Article  PubMed  Google Scholar 

  11. Murphy KP, McLaughlin PD, O’Connor OJ, Maher MM. Imaging the small bowel. Curr Opin Gastroenterol. 2014;30(2):134–40.

    Article  PubMed  Google Scholar 

  12. Saibeni S, Rondonotti E, Iozzelli A, Spina L, Tontini GE, Cavallaro F, Ciscato C, De Franchis R, Sardanelli F, Vecchi M. Imaging of the small bowel in Crohn’s disease: a review of old and new technique. World J Gastroenterol. 2007;13(24):3279–87.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Paparo F, Garlaschi A, Biscaldi E, Bacigalupo L, Cevasco L, Rollandi GA. Computed tomography of the bowel: a prospective comparison study between four techniques. Eur J Radiol. 2013;82(1):e1–10.

    Article  PubMed  Google Scholar 

  14. Gritzmann N, Hollerweger A, Macheiner P, Rettenbacher T. Transabdominal sonography of the gastrointestinal tract. Eur Radiol. 2002;12(7):1748–61.

    Article  PubMed  Google Scholar 

  15. Dambha F, Tanner J, Carroll N. Diagnostic imaging in Crohn’s disease: what is the new gold standard? Best Pract Res Clin Gastroenterol. 2014;28(3):421–36.

    Article  CAS  PubMed  Google Scholar 

  16. Masselli G, Gualdi G. CT and MR enterography in evaluating small bowel diseases: when to use which modality? Abdom Imaging. 2013;38(2):249–59.

    Article  PubMed  Google Scholar 

  17. Soyer P, Boudiaf M, Fishman EK, Hoeffel C, Dray X, Manfredi R, Marteau P. Imaging of malignant neoplasms of the mesenteric small bowel: new trends and perspectives. Crit Rev Oncol Hematol. 2011;80(1):10–30.

    Article  PubMed  Google Scholar 

  18. Paparo F, Bacigalupo L, Garello I, et al. Crohn’s disease: prevalence of intestinal and extraintestinal manifestations detected by computed tomography enterography with water enema. Abdom Imaging. 2012;37(3):326–37.

    Article  CAS  PubMed  Google Scholar 

  19. Mileto A, Ramirez-Giraldo JC, Marin D, Alfaro-Cordoba M, Eusemann CD, Scribano E, Blandino A, Mazziotti S, Ascenti G. Nonlinear image blending for dual-energy MDCT of the abdomen: can image quality be preserved if the contrast medium dose is reduced? AJR Am J Roentgenol. 2014;203(4):838–45.

    Article  PubMed  Google Scholar 

  20. Horsthuis K, Bipat S, Bennink RJ, Stoker J. Inflammation bowel disease diagnosed with US, MR, scintigraphy, and CT: Meta-analysis of prospective studies. Radiology. 2008;241(1):64–79.

    Article  Google Scholar 

  21. Froehlich JM, Patak MA, von Weymarn C, Juli CF, Zollikofer CL, Wentz KU. Small bowel motility assessment with magnetic resonance imaging. J Magn Reson Imaging. 2005;21(4):370–5.

    Article  PubMed  Google Scholar 

  22. Froehlich JM, Waldherr C, Stoupis C, Erturk SM, Patak MA. MR motility imaging in Crohn’s disease improves lesion detection compared with standard MR imaging. Eur Radiol. 2010;20(8):1945–51.

    Article  PubMed  Google Scholar 

  23. Maccioni F, Patak MA, Signore A, Laghi A. New frontiers of MRI in Crohn’s disease: motility imaging, diffusion-weighted imaging, perfusion MRI, MR spectroscopy, molecular imaging, and hybrid imaging (PET/MRI). Abdom Imaging. 2012;37(6):974–82.

    Article  PubMed  Google Scholar 

  24. Oussalah A, Laurent V, Bruot O, Bressenot A, Bigard MA, Régent D, Peyrin-Biroulet L. Diffusion-weighted magnetic resonance without bowel preparation for detecting colonic inflammation in inflammatory bowel disease. Gut. 2010;59(8):1056–65.

    Article  PubMed  Google Scholar 

  25. Oto A, Kayhan A, Williams JT, Fan X, Yun L, Arkani S, Rubin DT. Active Crohn’s disease in the small bowel: evaluation by diffusion weighted imaging and quantitative dynamic contrast enhanced MR imaging. J Magn Reson Imaging. 2011;33(3):615–24.

    Article  PubMed  Google Scholar 

  26. Boudiaf M, Soyer P, Terem C, Pelage JP, Maissiat E, Rymer R. Ct evaluation of small bowel obstruction. Radiographics. 2001;21(3):613–24.

    Article  CAS  PubMed  Google Scholar 

  27. Algin O, Evrimler S, Ozmen E, Metin MR, Ocakoglu G, Ersoy O, Karaoglanoglu M, Arslan H. A novel biphasic oral contrast solution for enterographic studies. J Comput Assist Tomogr. 2013;37(1):65–74.

    Article  PubMed  Google Scholar 

  28. Schreyer AG, Stroszczynski C. Radiological imaging of the small bowel. Dig Dis. 2011;29 Suppl 1:22–6.

    Article  PubMed  Google Scholar 

  29. Takenaka K, Ohtsuka K, Kitazume Y, Nagahori M, Fujii T, Saito E, Naganuma M, Araki A, Watanabe M. Comparison of magnetic resonance and balloon enteroscopic examination of the small intestine in patients with Crohn’s disease. Gastroenterology. 2014;147(2):334–42.

    Article  PubMed  Google Scholar 

  30. Elsayes KM, Al-Hawary MM, Jagdish J, Ganesh HS, Platt JF. CT enterography: principles, trends, and interpretation of findings. Radiographics. 2010;30(7):55–70.

    Google Scholar 

  31. Maglinte DD. Capsule imaging and the role of radiology in the investigation of diseases of the small bowel. Radiology. 2005;236(3):763–7.

    Article  PubMed  Google Scholar 

  32. Van Assche G, Dignass A, Panes J, Beaugerie L, Karagiannis J, Allez M, Ochsenkühn T, Orchard T, Rogler G, Louis E, Kupcinskas L, Mantzaris G, Travis S, Stange E, European Crohn’s and Colitis Organisation (ECCO). The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis. J Crohns Colitis. 2010;4(1):7–27.

    Article  PubMed  Google Scholar 

  33. Nevler A, Beer-Gabel M, Lebedyev A, Soffer A, Gutman M, Carter D, Zbar AP. Transperineal ultrasonography in perianal Crohn’s disease and recurrent cryptogenic fistula-in-ano. Colorectal Dis. 2013;15(8):1011–8.

    Article  CAS  PubMed  Google Scholar 

  34. Farraye FA, Adler DG, Chand B, Conway JD, Diehl DL, Kantsevoy SV, Kwon RS, Mamula P, Rodriguez SA, Shah RJ, Wong Kee Song LM, Tierney WM, ASGE Technology Committee. Update on CT colonography. Gastrointest Endosc. 2009;69(3):393–8.

    Article  PubMed  Google Scholar 

  35. Soyer P, Hamzi L, Sirol M, Duchat F, Dray X, Hristova L, Placé V, Pocard M, Boudiaf M. Colon cancer: comprehensive evaluation with 64-section CT colonography using water enema as intraluminal contrast agent-a pictorial review. Clin Imaging. 2012;36(2):113–25.

    Article  PubMed  Google Scholar 

  36. Rimola J, Ordás I. MR colonography in inflammatory bowel disease. Magn Reson Imaging Clin N Am. 2014;22(1):23–33.

    Article  PubMed  Google Scholar 

  37. Laghi A, Bellini D, Petrozza V, Piccazzo R, Santoro GA, Fabbri C, van der Paardt MP, Stoker J. Imaging of colorectal polyps and early rectal cancer. Colorectal Dis. 2015;17 Suppl 1:36–43.

    Article  PubMed  Google Scholar 

  38. Horsthuis K, Bipat S, Bennink RJ, Stoker J. Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: meta-analysis of prospective studies. Radiology. 2008;247(1):64–79.

    Article  PubMed  Google Scholar 

  39. Siddiki HA, Fidler JL, Fletcher JG, Burton SS, Huprich JE, Hough DM, Johnson CD, Bruining DH, Loftus Jr EV, Sandborn WJ, Pardi DS, Mandrekar JN. Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn’s disease. AJR Am J Roentgenol. 2009;193(1):113–21.

    Article  PubMed  Google Scholar 

  40. Amzallag-Bellenger E, Oudjit A, Ruiz A, Cadiot G, Soyer PA, Hoeffel CC. Effectiveness of MR enterography for the assessment of small-bowel diseases beyond Crohn disease. Radiographics. 2012;32(5):1423–44.

    Article  PubMed  Google Scholar 

  41. Quencer KB, Nimkin K, Mino-Kenudson M, Gee MS. Detecting active inflammation and fibrosis in pediatric Crohn’s disease: prospective evaluation of MR-E and CT-E. Abdom Imaging. 2013;38(4):705–13.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Grand DJ, Kampalath V, Harris A, Patel A, Resnick MB, Machan J, Beland M, Chen WT, Shah SA. MR enterography correlates highly with colonoscopy and histology for both distal ileal and colonic Crohn’s disease in 310 patients. Eur J Radiol. 2012;81(5):e763–9.

    Article  PubMed  Google Scholar 

  43. Jensen MD, Kjeldsen J, Rafaelsen SR, Nathan T. Diagnostic accuracies of MR enterography and CT enterography in symptomatic Crohn’s disease. Scand J Gastroenterol. 2011;46(12):1449–57.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Radiodiagnostic Unit, E.O. Ospedali Galliera, Mura della Cappuccine 14, Genoa, 16128, Italy

    Gian Andrea Rollandi & Luca Cevasco

Authors
  1. Gian Andrea Rollandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Luca Cevasco
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gian Andrea Rollandi .

Editor information

Editors and Affiliations

  1. Radiology Department, Policlinico Paolo Giaccone, Palermo, Italy

    Giuseppe Lo Re

  2. Radiology Department, University of Palermo, Policlinico Paolo Giaccone, Palermo, Italy

    Massimo Midiri

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Rollandi, G.A., Cevasco, L. (2016). Current Status of Imaging in Small and Large Bowel Diseases. In: Lo Re, G., Midiri, M. (eds) Crohn’s Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-23066-5_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-23066-5_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-23065-8

  • Online ISBN: 978-3-319-23066-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation