**Management of Disease**

**Chapter 5**

**The Imaging of Inflammatory Bowel Disease:**

Radiologic techniques play an integral role in the diagnosis and management of patients with inflammatory bowel disease (IBD). Imaging has long been utilized to evaluate seg‐ ments of the digestive tract that are inaccessible to conventional endoscopy. While endos‐ copy offers unparalleled visualization of the large bowel lumen and biopsy capabilities, the small bowel remains essentially wholly inaccessible by conventional endoscopic techniques [1]. Thus, one important role that imaging plays in the care of patients with IBD is the evalu‐

With the advancement of cross-sectional imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI), the role of imaging in IBD has greatly expanded to include the mucosal, transmural, extraluminal, and extra-intestinal manifestations of these diseases. Imaging now not only assists in making the diagnosis of IBD, including helping to discriminate between ulcerative colitis and Crohn's disease, but also is a critical component in the determination of active versus indolent disease. Imaging assessment of IBD activity is in‐ creasingly being utilized by surgeons and gastroenterologists for treatment planning and as a biomarker of treatment response/resistance. Urgent and emergent complications of IBD in‐ cluding abscesses, fistulae, perforations, obstructing strictures, and toxic megacolon are also best detected by cross-sectional imaging techniques over endoscopic methods [2]. Imaging is pivotal in the identification of extra-intestinal involvement of IBD, processes that both pro‐ vide important adjunctive data in the diagnosis of IBD as well as contribute significantly to the morbidity and mortality of IBD. Techniques such as MRI that provide superior soft tissue con‐ trast allow for both the improved visualization of the perianal disease manifestations of Crohn's disease such as fistulae and abscesses, as well as the precise anatomic localization for treatment planning [3]. Moreover, as our understanding of the pathophysiologic underpin‐ nings of IBD continually expands, novel molecular imaging approaches have been applied to

> © 2012 A. Sheth and S. Gee; licensee InTech. This is an open access article 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, provided the original work is properly cited.

> © 2012 The Author(s). Licensee InTech. 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, provided the original work is properly cited.

**Current Concepts and Future Directions**

Rahul A. Sheth and Michael S. Gee

http://dx.doi.org/10.5772/53025

**1. Introduction**

ation of the small bowel.

Additional information is available at the end of the chapter
