title: Imaging modalities in pediatric inflammatory bowel disease.
abstract: OBJECTIVE
  To review the various imaging modalities in the evaluation of pediatric inflammatory bowel disease (IBD) to determine disease location, clinical phenotype and the severity of disease in order to optimize treatment.
  
  
  RESULTS
  Assessment of the extent, location and severity of IBD routinely involves imaging of the gastrointestinal tract. Cross-sectional modalities such as magnetic resonance enterography (MRE) and computed tomography enterography visualize the lumen, transmural involvement, extraintestinal manifestations and may facilitate decision-making in disease management. MRE has evolved as the imaging modality of choice for many pediatric IBD indications because it does not involve exposure to ionizing radiation.
  
  
  CONCLUSIONS
  Advances in imaging modalities have revolutionized the assessment of children with IBD in recent years. Small-bowel follow-through is no longer considered the imaging modality of choice in this setting. Cross-sectional enterography is now preferred because, among other advantages, it can potentially distinguish active inflammation from fibrosis, characterize stricturing and penetrating complications, and diagnose extraintestinal manifestations. Although MRE avoids ionizing radiation exposure, it remains costly. Cross-sectional imaging and endoscopy complement each other in the development of objective measures for the assessment of disease activity and monitoring of response to treatment.
authors.affiliation: aDivision of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio bDepartment of Radiology cDivision of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Ross
authors.initials: R
authors.lastname: Maltz
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Podberesky
authors.forename: Shehzad A
authors.initials: SA
authors.lastname: Saeed
mesh_terms: D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005471:Fluoroscopy; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007249:Inflammation / Q000473:pathology; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed