Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada.
AJR Am J Roentgenol. 2012 Oct;199(4):907-15. doi: 10.2214/AJR.11.7966.
The goal of this review is to examine the current imaging literature and develop basic imaging guidelines for evaluation of children with inflammatory bowel disease (IBD). The three following typical clinical scenarios in the imaging evaluation of IBD are considered: patient with an initial diagnosis of suspected IBD, the goals being to determine disease extent and severity and to differentiate Crohn disease from ulcerative colitis; patient with known IBD presenting with new acute symptoms (fever, peritonitis, leukocytosis) requiring urgent evaluation; and patient with known IBD presenting with nonacute symptomatic recurrence (abdominal pain, diarrhea), the goals being to assess the efficacy of the current treatment and to evaluate the possible need for additional medical or surgical intervention.
Imaging of pediatric patients with IBD must balance considerations of diagnostic accuracy against concerns about patient exposure to ionizing radiation and tolerance of the imaging technique. The imaging modality chosen depends on the clinical presentation and expected pathologic finding.
本综述旨在检查当前的影像学文献，并为评估炎症性肠病（IBD）患儿制定基本的影像学指南。考虑了 IBD 影像学评估中的以下三种典型临床情况：疑似 IBD 初始诊断的患者，目的是确定疾病的范围和严重程度，并区分克罗恩病和溃疡性结肠炎；已知 IBD 并出现新的急性症状（发热、腹膜炎、白细胞增多）需要紧急评估的患者；以及已知 IBD 并出现非急性症状性复发（腹痛、腹泻）的患者，目的是评估当前治疗的效果，并评估是否需要额外的医疗或手术干预。
对患有 IBD 的儿科患者进行影像学检查必须在诊断准确性与患者接受电离辐射的考虑以及对影像学技术的耐受性之间取得平衡。选择的影像学方式取决于临床表现和预期的病理发现。
