Diagnostic imaging tools for inflammatory bowel disease

Novel diagnostic advances in inflammatory bowel disease are complementary to clinical assessment, colonoscopy, and small bowel x ray. The wireless video capsule, in its current form, is of value in the diagnosis of Crohn's disease when the condition is suspected and conventional studies are negative or technically impossible. The sensitivity of WCE is very high but specificity has yet to be determined. MRI, with or without enteroclysis, has a well established role. It uses non-ionising radiation and therefore is a potentially ideal imaging modality, especially in patients who require repeated studies. MRI is advantageous in patients with equivocal studies and is a crucial tool in distinguishing inflammation from fibrosis in patients with obstructive symptoms. Endoscopic US has a role primarily in the assessment of perianal disease. The roles of MR colonography, Doppler US, and double balloon enteroscopy hold promise but further studies are necessary as their roles are not well defined. Inflammatory bowel disease is a clinical diagnosis aided by imaging studies. Conventional imaging studies remain the mainstays of investigation but novel imaging techniques developed and enhanced over the past five years have greatly advanced diagnostic capabilities.