ABSTRACT
Ultrasound has long been favoured as first line when imaging children, primarily due to it being a non-invasive, relatively low cost, easily accessible modality. The many advantages of ultrasound evaluation in paediatric inflammatory bowel disease (IBD) vastly outweighs its limitations in both initial assessment and long term follow up. High frequency ultrasound provides excellent spatial resolution, and Doppler evaluation and compression sonography aids in providing real-time dynamic assessment in IBD where other modalities cannot. This paper outlines our ultrasound technique to maximise image quality and diagnostic accuracy, describes the imaging findings in paediatric IBD, and explores the advantages and limitations that ultrasound offers. We aim to illustrate to the reader that ultrasound is an invaluable imaging tool and should be the first line modality when imaging IBD in the paediatric patient.
Subject(s)
Colitis, Ulcerative/diagnosis , Crohn Disease/diagnosis , Child , Cost-Benefit Analysis , Female , Humans , Intestines/diagnostic imaging , Male , Ultrasonography , Ultrasonography, DopplerSubject(s)
Caliciviridae Infections/diagnosis , Enteritis/diagnosis , Kidney Transplantation/adverse effects , Norovirus/isolation & purification , Plasma Exchange/adverse effects , Thrombotic Microangiopathies/diagnosis , Transplantation , Adult , Caliciviridae Infections/pathology , Enteritis/complications , Enteritis/pathology , Female , Humans , Radiography, Abdominal , Thrombotic Microangiopathies/complications , Thrombotic Microangiopathies/pathology , Tomography, X-Ray ComputedABSTRACT
Crohn's disease begins in childhood in 20% of cases. Imaging of the small bowel is needed for diagnosis and management and also to inform the clinician of the location, extent, and activity of disease. There are several modalities available to image the small bowel and the combined use of these is often required to optimise benefit. Methods available for imaging the small bowel include barium studies, sonography, CT, wireless capsule endoscopy, nuclear medicine studies, and MRI. Patient comfort is paramount in imaging paediatric patients. Therefore, non-invasive techniques are most likely to be successful. Furthermore, as children are at greatest risk of radiation induced malignancy, modalities which do not carry a radiation burden are preferable. This article discusses the methods available for imaging the small bowel in paediatric Crohn's disease and the relative merits of each modality.
