Sistema Gastrointestinal e Digestivo

Abstrato

Bowel Imaging in IBD Patients: Review of the Literature and Current Recommendations

Lahat A and Fidder HH

Imaging studies are essential in the diagnosis, treatment and follow up of IBD patients. The use of bowel imaging serves to confirm the diagnosis, assess disease extent and characteristics (inflammatory versus fibrostenotic) and complications. Accepted methods for bowel imaging in IBD patients are: CT enterography (CTE), MR enteropgaraphy (MRE), Abdominal ultrasound and capsule endoscopy. Each technique has its advantages and disadvantages. IBD patients have relatively high risk for colorectal cancer, small bowel cancer lymphomas and other malignancies. This risk is related to the chronic inflammatory process as well as to immunosuppressive therapy. Accumulating data shows that exposure to ionizing radiation elevates the risk for malignancy. Even exposure to relatively low doses of radiation as 50 mSv was shown to cause an increase in the occurrence of solid tumors, mainly colorectal cancer and urogenital malignancies. Individualized approach considering patients' symptoms, age, medical history, previous radiation exposure and malignancy risk as well as the local facilities and experience should guide physicians' decision regarding the preferred imaging modality.