**3. What is the new gold standard?**

Barium contrast tests and isotopes have been used to show inflammatory bowel disease, but they carry a risk of ionizing radiation exposure. Barium use is declining to result in fewer radiologists having the expertise and experience for such examinations - the lack of anatomical localizations limits isotopic studies.

CT is beneficial for assessing Crohn's disease complications, but it is burdened with high radiation.

CT enterography improves the visualization of the small bowel disease and allows the assessment of the disease activity.

Ultrasound has been increasingly used for the preliminary assessment of patients with potential IBD [55–59]. Although it is widely available and inexpensive, it depends on the experience of the doctor.

Finally, MRI is the most accurate tool for assessing the disease, its severity, and its prevalence [42–44, 60]. Pelvic MRI completely suppressed other techniques in the assessment of perianal fistulas [61].

According to the latest ECCO guidelines for the diagnosis of Crohn's disease, endoscopy and radiology are complementary techniques to define the site and extension of the disease so that optimal therapy can be planned [62].

**19**

*Role of Imaging in Small Bowel Crohn's Disease DOI: http://dx.doi.org/10.5772/intechopen.96098*

fistulas, perianal fistulas in particular.

The authors declare no conflict of interest.

\*, Enver Zerem<sup>2</sup>

provided the original work is properly cited.

and Emir Gušo1

© 2021 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

1 Department of Radiology, General Hospital Sarajevo, Sarajevo,

\*Address all correspondence to: bilal\_imsirovic@yahoo.com

2 Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo,

**Conflict of interest**

**Author details**

Bilal Imširović1

Bosnia and Herzegovina

Bosnia and Herzegovina

Conventional ultrasound is a suitable orientation method in the initial evaluation of the patients with Crohn's disease. It can be used as an initial method for the patients who will subsequently undergo MRI enterography. CT is beneficial for assessing Crohn's disease complications, but it is burdened with high radiation.

Contrast MRI enterography provides an excellent assessment of disease activity, as well as the complications that accompany it. The method has a high sensitivity to changes seen in the patients with Crohn's disease; it offers detailed morphological and functional data on the small bowel disease and reliable evidence of normalcy; thus, it facilitates the final diagnosis of early or subtle structural abnormalities and helps to guide treatment and decisions on a further follow-up of patients. Contrast MRI enterography, in combination with DWI, is a comprehensive and safe method compared to reference - endoscopic examinations, and it should be considered as the preliminary examination for the detection of lesions in Crohn's disease, especially in children. Given the convenience and considering the safety and ease of the analysis, MRI enterography combined with DWI is suitable for repeated followup examinations, i.e. it can contribute to the follow-up of patients with Crohn's disease. Contrast MRI enterography combined with DWI is an excellent tool for evaluating complications of the underlying condition, especially for detecting

**4. Conclusions**
