Imaging Inflammatory Bowel Disease with CT and MR Enterography

Radiologic imaging plays a crucial role in the diagnosis and management of Crohn’s disease (CD). With cross-sectional imaging techniques in particular, the bowel lumen, wall, and extraintestinal manifestations of the disease can be visualized efficiently and noninvasively. Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are the new gold standards of imaging inflammatory bowel disease, replacing the small-bowel follow-through as the first-line imaging test of choice. The choice between modalities is largely one of availability, experience and institutional or individual preference. CTE may be preferred in older patients and those presenting with acute symptoms, due to its low cost, ease of execution/interpretation, and greater availability. Magnetic resonance imaging (MRI) is often favored in young patients to minimize exposure to ionizing radiation. The efficacy of both CTE and MRE has been repeatedly proven; the future of radiographic imaging of CD lies in the ability to differentiate between active inflammation and fibrosis, as well as to monitor the effectiveness of treatment.