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Diagnostics: The Future

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Crohn’s Disease

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Abstract

Imaging of Crohn’s disease is continuously evolving with new imaging techniques moving beyond anatomical information to provide functional information that can aid in therapeutic decisions and monitoring therapy. Multiple emerging MRI techniques for small bowel imaging aim at differentiating active inflammation from fibrostenotic disease and provide the potential for quantitative imaging of disease assessment and treatment monitoring. Some of these techniques (such as diffusion weighted imaging, motility imaging, and high resolution imaging) are clinically available but need to be further validated in larger studies. Some techniques are less accessible clinically such as dynamic contrast enhancement of the bowel. Other techniques such as magnetization transfer are in the early research phase. New CT techniques are mainly focused on radiation dose reduction and are becoming more available in clinical practice. Dual energy CT may have additional theoretical potentials in assessing bowel perfusion, but remains largely uninvestigated in Crohn’s disease. PET-CT has the potential for assessing degree of inflammation. Future developments may focus on new PET radiopharmaceuticals that can be more specific for inflammation. Contrast-enhanced ultrasound can provide the potential for quantitative assessment of disease activity in selected bowel segments. US elastography of the bowel is in the very early stages of research.

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Abbreviations

ADC:

Apparent diffusion coefficient

ASIR:

Adaptive statistical iterative reconstruction

bSSFP:

Balanced steady state free precession

CD:

Crohn’s disease

CEUS:

Contrast-enhanced ultrasound

CNR:

Contrast to noise ratio

DCE-MRI:

Dynamic contrast-enhanced magnetic resonance imaging

DWI:

Diffusion weighted imaging

FBP:

Filtered back projection

FDG-PET:

Flouro-deoxy-glucose positron emission tomography

MI:

Motility index

MT:

Magnetization transfer

SSFSE:

Single shot fast spin echo

SNR:

Signal to noise ratio

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Authors and Affiliations

  1. Department of Radiology, Loyola University Chicago, Stritch School of Medicine, 2160 S. 1st Avenue, Maywood, IL, 60153, USA

    Joseph H. Yacoub MD

  2. Department of Radiology, University of Chicago, 5841 S. Maryland Avenue, MC 2026, Chicago, IL, 60637, USA

    Aytekin Oto MD

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  1. Joseph H. Yacoub MD
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  2. Aytekin Oto MD
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Correspondence to Aytekin Oto MD .

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Editors and Affiliations

  1. Department of Surgery, University of Washington Medical Center, Seattle, Washington, USA

    Alessandro Fichera

  2. Department of Surgery, University of Washington Medical Center, Seattle, Washington, USA

    Mukta K. Krane

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Yacoub, J.H., Oto, A. (2015). Diagnostics: The Future. In: Fichera, A., Krane, M. (eds) Crohn’s Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-14181-7_9

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  • DOI: https://doi.org/10.1007/978-3-319-14181-7_9

  • Publisher Name: Springer, Cham

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