The potential of radiologic procedures in the diagnosis of inflammatory bowel disease

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Abstract

At present, there is no "golden standard" of diagnosis of inflammatory bowel disease. Each and every individual case requires a thorough analysis of clinical symptoms in their association with endoscopic, histological, radiological and laboratory data. This review paper analyzes both conventional and novel methods of radiological investigations. Some of them have changed their significance from the "golden standard" to rare and limited application and from promising, then frequent and currently sporadic use of small bowel enema. Traditional ileocolonoscopy maintains its diagnostic potential, especially as a tool for follow up of patients with colonic and ileac disorders. The state-of-the-art non-invasive (ultrasound examination) and limitedly non-invasive (computerized tomography and magnetic resonance imaging) procedures are considered to be the most accurate methods for assessment of inflammatory bowel disorders in patient with already confirmed diagnosis and those with suspected cases of Crohn's disease and ulcerative colitis. The paper describes preparation of patient for each method, assessment technique, advantages and limitations for use, diagnostic criteria for intestinal wall thickness, accuracy of methods and discusses the perspectives of their use. The main sign of inflammatory bowel disease is thickening of intestinal wall. Usually its mean thickness in Crohn's disease (11 to 13 mm) is higher than that in ulcerative colitis (7 to 8 mm). This may provide a diagnostic key during differential diagnosis of an isolated colon disease. The amount of the contrast cumulated by the intestinal wall directly correlates with inflammation activity. Intensive contract cumulation in the intestinal wall after intravenous contrast enhancement is a symptom of active inflammatory process. However, despite progression in the technologies, initial signs of inflammatory bowel diseases are quite superficial and remain hardly visible, being below the resolution ability of any diagnostic investigation.

About the authors

S. E. Dubrova

Moscow Regional Research and Clinical Institute, Moscow

Author for correspondence.
Email: dubrovamoniki@rambler.ru

Dubrova Sofiya E. – MD, PhD, Physician, Department of Roentgenology; Assistant, Chair of Radiology, Postgraduate Training Faculty.

61/2-1 Shchepkina ul., Moscow, 129110, Russian Federation. Tel.: +7 (495) 681 66 42. E-mail: dubrovamoniki@rambler.ru Russian Federation

G. A. Stashuk

Moscow Regional Research and Clinical Institute, Moscow

Email: fake@neicon.ru
Stashuk Galina A. – MD, PhD, Professor, Chief Research Fellow, Department of Roentgenology; Chair of Radiology, Postgraduate Training Faculty Russian Federation

References

  1. Molodecky NA, Soon IS, Rabi DM, Ghali WA, Ferris M, Chernoff G, Benchimol EI, Panac-cione R, Ghosh S, Barkema HW, Kaplan GG. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterol-ogy. 2012;142(1):46-54.e42; quiz e30. doi: 10.1053/j.gastro.2011.10.001.
  2. Ивашкин ВТ, Лапина ТЛ, ред. Гастроэнтерология. Национальное руководство. М.: ГЭОТАР-Медиа; 2008. 754 c.
  3. Румянцев ВГ. Язвенный колит. Руководство для врачей. М.: МИА; 2009. 424 с.
  4. Dignass A, Eliakim R, Magro F, Maaser C, Chow-ers Y, Geboes K, Mantzaris G, Reinisch W, Co-lombel JF, Vermeire S, Travis S, Lindsay JO, Van Assche G. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 1: definitions and diagnosis. J Crohns Colitis. 2012;6(10):965-90. doi: 10.1016/j.crohns.2012.09.003.
  5. Дуброва СЭ, Сташук ГА, Горбачева ЮВ. Болезнь Крона тонкой кишки. Экспериментальная и клиническая гастроэнтерология. 2014;104(4):60-2.
  6. Белоусова ЕА. Рекомендации по диагностике и лечению болезни Крона. Фарматека. 2009;(13):38-44.
  7. Белоусова ЕА, Морозова НА, Цодикова ОМ, Сташук ГА, Гаганов ЛЕ. Отдаленные результаты лечения болезни Крона инфликсимабом. Экспериментальная и клиническая гастроэнтерология. 2015;117(5):76.
  8. Воробьев ГИ, Халиф ИЛ. Неспецифические воспалительные заболевания кишечника. М.: Миклош; 2008. 422 с.
  9. Nicholson BD, Hyland R, Rembacken BJ, De-nyer M, Hull MA, Tolan DJ. Colonoscopy for colonic wall thickening at computed tomography: a worthwhile pursuit? Surg Endosc. 2011;25(8):2586-91. doi: 10.1007/s00464-011-1591-7.
  10. Сташук ГА, Дуброва СЭ, Петухова НЮ. Лучевая диагностика болезни Крона. Протокол заседания секции абдоминальной радиологии Московского общества медицинских радиологов от 17 марта 2010 г. Медицинская визуализация. 2010;(3):129-32.
  11. Panes J, Bouhnik Y, Reinisch W, Stoker J, Taylor SA, Baumgart DC, Danese S, Halligan S, Marincek B, Matos C, Peyrin-Biroulet L, Ri-mola J, Rogler G, van Assche G, Ardizzone S, Ba-Ssalamah A, Bali MA, Bellini D, Biancone L, Castiglione F, Ehehalt R, Grassi R, Kuchar-zik T, Maccioni F, Maconi G, Magro F, Martin-Comin J, Morana G, Pendse D, Sebastian S, Signore A, Tolan D, Tielbeek JA, Weishaupt D, Wiarda B, Laghi A. Imaging techniques for assessment of inflammatory bowel disease: joint ECCO and ESGAR evidence-based consensus guidelines. J Crohns Colitis. 2013;7(7):556-85. doi: 10.1016/j.crohns.2013.02.020.
  12. Stange EF, Travis SP, Vermeire S, Beglinger C, Kupcinkas L, Geboes K, Barakauskiene A, Vil-lanacci V, Von Herbay A, Warren BF, Gasche C, Tilg H, Schreiber SW, Scholmerich J, Reinisch W; European Crohn's and Colitis Organisation. European evidence based consensus on the diagnosis and management of Crohn's disease: definitions and diagnosis. Gut. 2006;55 Suppl 1:i1-15. doi: 10.1136/gut.2005.081950a.
  13. Hommes DW, van Deventer SJ. Endoscopy in inflammatory bowel diseases. Gastroenterology. 2004;126(6):1561-73. doi: http://dx.doi.org/10.1053/j.gastro.2004.03.023.
  14. Kundrotas LW, Clement DJ, Kubik CM, Robinson AB, Wolfe PA. A prospective evaluation of successful terminal ileum intubation during routine colonoscopy. Gastrointest Endosc. 1994;40(5):544-6.
  15. Marshall JB, Barthel JS. The frequency of total colonoscopy and terminal ileal intubation in the 1990s. Gastrointest Endosc. 1993;39(4):518-20.
  16. Kato S, Fujii T, Koba I, Sano Y, Fu KI, Parra-Blan-co A, Tajiri H, Yoshida S, Rembacken B. Assessment of colorectal lesions using magnifying colonoscopy and mucosal dye spraying: can significant lesions be distinguished? Endoscopy. 2001;33(4):306-10. doi: 10.1055/s-2001-13700.
  17. Maunoury V, Mordon S, Klein O, Colombel JF. Fluorescence endoscopic imaging study of anastomotic recurrence of Crohn's disease. Gastrointest Endosc. 1996;43(6):603-4.
  18. Maccioni F. Introduction to the feature section on "Crohn's disease activity: MRI assessment and clinical implications". Abdom Imaging. 2012;37(6):917-20. doi: 10.1007/s00261-012-9874-6.
  19. Cipriano LE, Levesque BG, Zaric GS, Loftus EV Jr, Sandborn WJ. Cost-effectiveness of imaging strategies to reduce radiation-induced cancer risk in Crohn's disease. Inflamm Bowel Dis. 2012;18(7):1240-8. doi: 10.1002/ibd.21862.
  20. Jensen MD, Kjeldsen J, Rafaelsen SR, Nathan T. Diagnostic accuracies of MR enterography and CT enterography in symptomatic Crohn's disease. Scand J Gastroenterol. 2011;46(12):1449-57. doi: 10.3109/00365521.2011.613947.
  21. Pallotta N, Tomei E, Viscido A, Calabrese E, Marcheggiano A, Caprilli R, Corazziari E. Small intestine contrast ultrasonography: an alternative to radiology in the assessment of small bowel disease. Inflamm Bowel Dis. 2005;11(2):146-53.
  22. Parente F, Greco S, Molteni M, Anderloni A, Sampietro GM, Danelli PG, Bianco R, Gallus S, Bianchi Porro G. Oral contrast enhanced bowel ultrasonography in the assessment of small intestine Crohn's disease. A prospective comparison with conventional ultrasound, x ray studies, and ileocolonoscopy. Gut. 2004;53(11):1652-7. doi: 10.1136/gut.2004.041038.
  23. Miao YM, Koh DM, Amin Z, Healy JC, Chinn RJ, Zeegen R, Westaby D. Ultrasound and magnetic resonance imaging assessmentof active bowel segments in Crohn's disease. Clin Radiol. 2002;57(10):913-8. doi: http://dx.doi.org/10.1053/crad.2002.1059.
  24. Rispo A, Imbriaco M, Celentano L, Cozzolino A, Camera L, Mainenti PP, Manguso F, Sabbatini F, D'Amico P, Castiglione F. Noninvasive diagnosis of small bowel Crohn's disease: combined use of bowel sonography and Tc-99m-HMPAO leukocyte scintigraphy. Inflamm Bowel Dis. 2005;11(4):376-82.
  25. Andreoli A, Cerro P, Falasco G, Giglio LA, Prant-era C. Role of ultrasonography in the diagnosis of postsurgical recurrence of Crohn's disease. Am J Gastroenterol. 1998;93(7):1117-21. doi: 10.1111/j.1572-0241.1998.00340.x.
  26. De Franco A, Di Veronica A, Armuzzi A, Roberto I, Marzo M, De Pascalis B, De Vitis I, Papa A, Bock E, Danza FM, Bonomo L, Guidi L. Ileal Crohn disease: mural microvascularity quantified with contrast-enhanced US correlates with disease activity. Radiology. 2012;262(2):680-8. doi: 10.1148/radiol.11110440.
  27. Schreyer AG, Finkenzeller T, Gossmann H, Dan-eschnejad M, Muller-Wille R, Schacherer D, Zu-ber-Jerger I, Strauch U, Feuerbach S, Jung EM. Microcirculation and perfusion with contrast enhanced ultrasound (CEUS) in Crohn's disease: first results with linear contrast harmonic imaging (CHI). Clin Hemorheol Microcirc. 2008;40(2):143-55. doi: 10.3233/CH-2008-1125.
  28. Quaia E, De Paoli L, Stocca T, Cabibbo B, Casa-grande F, Cova MA. The value of small bowel wall contrast enhancement after sulfur hexa-fluoride-filled microbubble injection to differentiate inflammatory from fibrotic strictures in patients with Crohn's disease. Ultrasound Med Biol. 2012;38(8):1324-32. doi: 10.1016/j.ultras-medbio.2012.04.008.
  29. Pallotta N, Vincoli G, Montesani C, Chirlet-ti P, Pronio A, Caronna R, Ciccantelli B, Romeo E, Marcheggiano A, Corazziari E. Small intestine contrast ultrasonography (SICUS) for the detection of small bowel complications in Crohn's disease: a prospective comparative study versus intraoperative findings. Inflamm Bowel Dis. 2012;18(1):74-84. doi: 10.1002/ibd.21678.
  30. Parente F, Greco S, Molteni M, Cucino C, Ma-coni G, Sampietro GM, Danelli PG, Cristaldi M, Bianco R, Gallus S, Bianchi Porro G. Role of early ultrasound in detecting inflammatory intestinal disorders and identifying their anatomical location within the bowel. Aliment Pharmacol Ther. 2003;18(10):1009-16. doi: 10.1046/j.1365-2036.2003.01796.x.
  31. Calabrese E, La Seta F, Buccellato A, Virdone R, Pallotta N, Corazziari E, Cottone M. Crohn's disease: a comparative prospective study of transabdominal ultrasonography, small intestine contrast ultrasonography, and small bowel enema. Inflamm Bowel Dis. 2005;11(2):139—45.
  32. Nylund K, Hausken T, Gilja OH. Ultrasound and inflammatory bowel disease. Ultrasound Q. 2010;26(1):3-15. doi: 10.1097/RUQ.0b013e3181ce0929.
  33. Antonelli E, Giuliano V, Casella G, Villanac-ci V, Baldini V, Baldoni M, Morelli O, Bassot-ti G. Ultrasonographic assessment of colonic wall in moderate-severe ulcerative colitis: comparison with endoscopic findings. Dig Liver Dis. 2011;43(9):703-6. doi: 10.1016/j.dld.2011.02.019.
  34. Martinez MJ, Ripolles T, Paredes JM, Blanc E, Marti-Bonmati L. Assessment of the extension and the inflammatory activity in Crohn's disease: comparison of ultrasound and MRI. Abdom Imaging. 2009;34(2):141-8. doi: 10.1007/s00261-008-9365-y.
  35. Maconi G, Sampietro GM, Parente F, Pompili G, Russo A, Cristaldi M, Arborio G, Ardizzone S, Matacena G, Taschieri AM, Bianchi Porro G. Contrast radiology, computed tomography and ultrasonography in detecting internal fistulas and intra-abdominal abscesses in Crohn's disease: a prospective comparative study. Am J Gastroenterol. 2003;98(7):1545-55. doi: 10.1111/j.1572-0241.2003.07521.x.
  36. Parente F, Maconi G, Bollani S, Anderloni A, Sampietro G, Cristaldi M, Franceschelli N, Bianco R, Taschieri AM, Bianchi Porro G. Bowel ultrasound in assessment of Crohn's disease and detection of related small bowel strictures: a prospective comparative study versus x ray and intraoperative findings. Gut. 2002;50(4):490-5. doi: 10.1136/gut.50.4.490.
  37. Arienti V, Campieri M, Boriani L, Gionchet-ti P, Califano C, Giancane S, Furno A, Gasbarri-ni G. Management of severe ulcerative colitis with the help of high resolution ultrasonogra-phy. Am J Gastroenterol. 1996;91(10):2163-9.
  38. Sigirci A, Baysal T, Kutlu R, Aladag M, Sara? K, Harputluoglu H. Doppler sonography of the inferior and superior mesenteric arteries in ulcerative colitis. J Clin Ultrasound. 2001;29(3):130-9.
  39. Spalinger J, Patriquin H, Miron MC, Marx G, Herzog D, Dubois J, Dubinsky M, Seidman EG. Doppler US in patients with Crohn disease: vessel density in the diseased bowel reflects disease activity. Radiology. 2000;217(3):787-91. doi: 10.1148/radiology.217.3.r00dc19787.
  40. Marmo R, Rotondano G, Piscopo R, Bianco MA, Cipolletta L. Meta-analysis: capsule enteros-copy vs. conventional modalities in diagnosis of small bowel diseases. Aliment Pharmacol Ther. 2005;22(7):595-604. doi: 10.1111/j.1365-2036.2005.02625.x.
  41. Paulsen SR, Huprich JE, Fletcher JG, Booya F, Young BM, Fidler JL, Johnson CD, Barlow JM, Earnest F 4th. CT enterography as a diagnostic tool in evaluating small bowel disorders: review of clinical experience with over 700 cases. Radiographics. 2006;26(3):641-57. doi: 10.1148/rg.263055162.
  42. Macari M, Megibow AJ, Balthazar EJ. A pattern approach to the abnormal small bowel: observations at MDCT and CT enterography. AJR Am J Roentgenol. 2007;188(5):1344-55. doi: 10.2214/AJR.06.0712.
  43. Mazzeo S, Caramella D, Battolla L, Melai L, Masolino P, Bertoni M, Giusti P, Cappelli C, Bar-tolozzi C. Crohn disease of the small bowel: spiral CT evaluation after oral hyperhydration with isotonic solution. J Comput Assist Tomogr. 2001;25(4):612-6.
  44. Lalitha P, Reddy MCh, Reddy KJ, Kumari MV. Computed tomography enteroclysis: a review. Jpn J Radiol. 2011;29(10):673-81. doi: 10.1007/s11604-011-0621-7.
  45. Wold PB, Fletcher JG, Johnson CD, Sand-born WJ. Assessment of small bowel Crohn disease: noninvasive peroral CT enterogra-phy compared with other imaging methods and endoscopy feasibility study. Radiology. 2003;229(1):275-81. doi: 10.1148/radi-ol.2291020877.
  46. Beister M, Kolditz D, Kalender WA. Iterative reconstruction methods in X-ray CT. Phys Med. 2012;28(2):94-108. doi: 10.1016/j.ejmp.2012.01.003.
  47. Del Gaizo AJ, Fletcher JG, Yu L, Paden RG, Spencer GC, Leng S, Silva AM, Fidler JL, Silva AC, Hara AK. Reducing radiation dose in CT en-terography. Radiographics. 2013;33(4):1109-24. doi: 10.1148/rg.334125074.
  48. Bodily KD, Fletcher JG, Solem CA, Johnson CD, Fidler JL, Barlow JM, Bruesewitz MR, McCollough CH, Sandborn WJ, Loftus EV Jr, Harmsen WS, Crownhart BS. Crohn Disease: mural attenuation and thickness at contrast-enhanced CT Enterography correlation with endoscopic and histologic findings of inflammation. Radiology. 2006;238(2):505-16. doi: 10.1148/radiol.2382041159.
  49. Booya F, Fletcher JG, Huprich JE, Barlow JM, Johnson CD, Fidler JL, Solem CA, Sandborn WJ, Loftus EV Jr, Harmsen WS. Active Crohn disease: CT findings and interobserver agreement for enteric phase CT enterography. Radiology. 2006;241(3):787-95. doi: 10.1148/radiol.2413051444.
  50. Thoeni RF, Cello JP. CT imaging of colitis. Radiology. 2006;240(3):623-38. doi: 10.1148/ra-diol.2403050818.
  51. Minordi LM, Vecchioli A, Guidi L, Mirk P, Fioren-tini L, Bonomo L. Multidetector CT enteroclysis versus barium enteroclysis with methylcellu-lose in patients with suspected small bowel disease. Eur Radiol. 2006;16(7):1527-36. doi: 10.1007/s00330-006-0185-6.
  52. Triester SL, Leighton JA, Leontiadis GI, Guru-du SR, Fleischer DE, Hara AK, Heigh RI, Shiff AD, Sharma VK. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn's disease. Am J Gastroenterol. 2006;101(5):954-64. doi: 10.1111/j.1572-0241.2006.00506.x. New concepts in intestinal imaging for inflammatory bowel diseases. Gastroenterology. 2011;140(6):1795-806. doi: 10.1053/j.gastro.2011.02.013.
  53. Arumugam R, Rakesh S, editors. Crohn's Disease. Current Concepts. Cham: Springer; 2015. 178 p. doi: 10.1007/978-3-319-01913-0.
  54. Хомутова ЕЮ, Игнатьев ЮТ, Скрипкин ДА, Филлипова ЮГ. Виртуальная колоноскопия: методика проведения. Радиология -практика. 2009;(2):21-7.
  55. Biancone L, Fiori R, Tosti C, Marinetti A, Catari-nacci M, De Nigris F, Simonetti G, Pallone F. Virtual colonoscopy compared with conventional colonoscopy for stricturing postoperative recurrence in Crohn's disease. Inflamm Bowel Dis. 2003;9(6):343-50.
  56. Sinha R, Rawat S. MRI enterography with divided dose oral preparation: Effect on bowel distension and diagnostic quality. Indian J Radiol Imaging. 2013;23(1):86-91. doi: 10.4103/09713026.113623.
  57. Schreyer AG, Geissler A, Albrich H, Scholmer-ich J, Feuerbach S, Rogler G, Volk M, Her-farth H. Abdominal MRI after enteroclysis or with oral contrast in patients with suspected or proven Crohn's disease. Clin Gastroenterol Hepatol. 2004;2(6):491-7. doi: http://dx.doi.org/10.1016/S1542-3565(04)00168-5.
  58. Ajaj W, Goehde SC, Schneemann H, Ruehm SG, Debatin JF, Lauenstein TC. Oral contrast agents for small bowel MRI: comparison of different additives to optimize bowel distension. Eur Radiol. 2004;14(3):458-64. doi: 10.1007/s00330-003-2177-0.
  59. Sinha R, Rajiah P, Ramachandran I, Sanders S, Murphy PD. Diffusion-weighted MR imaging of the gastrointestinal tract: technique, indications, and imaging findings. Radiographics. 2013;33(3):655-76. doi: 10.1148/rg.333125042.
  60. Maccioni F, Bruni A, Viscido A, Colaiacomo MC, Cocco A, Montesani C, Caprilli R, Marini M. MR imaging in patients with Crohn disease: value of T2-versus T1-weighted gadolinium-enhanced MR sequences with use of an oral super paramagnetic contrast agent. Radiology. 2006;238(2):517-30. doi: 10.1148/radiol.2381040244.
  61. Florie J, Horsthuis K, Hommes DW, Nio CY, Reitsma JB, van Deventer SJ, Stoker J. Magnetic resonance imaging compared with ile-ocolonoscopy in evaluating disease severity in Crohn's disease. Clin Gastroenterol Hepatol. 2005;3(12):1221-8. doi: http://dx.doi. org/10.1016/S1542-3565(05)00853-0.
  62. Maccioni F, Colaiacomo MC, Parlanti S. Ulcer-ative colitis: value of MR imaging. Abdom Imaging. 2005;30(5):584-92. doi: 10.1007/s00261-004-0284-2.
  63. Peyrin-Biroulet L, Reinisch W, Colombel JF, Mantzaris GJ, Kornbluth A, Diamond R, Rut-geerts P, Tang LK, Cornillie FJ, Sandborn WJ. Clinical disease activity, C-reactive protein normalisation and mucosal healing in Crohn's disease in the SONIC trial. Gut. 2014;63(1):88-95. doi: 10.1136/gutjnl-2013-304984.
  64. Golder SK, Schreyer AG, Endlicher E, Feuer-bach S, Scholmerich J, Kullmann F, Seitz J, Rogler G, Herfarth H. Comparison of capsule endoscopy and magnetic resonance (MR) en-teroclysis in suspected small bowel disease. Int J Colorectal Dis. 2006;21(2):97-104. doi: 10.1007/s00384-005-0755-0.
  65. Umschaden HW, Szolar D, Gasser J, Um-schaden M, Haselbach H. Small-bowel disease: comparison of MR enteroclysis images with conventional enteroclysis and surgical findings. Radiology. 2000;215(3):717-25. doi: 10.1148/radiology.215.3.r00jn12717.
  66. Koh DM, Miao Y, Chinn RJ, Amin Z, Zeegen R, Westaby D, Healy JC. MR imaging evaluation of the activity of Crohn's disease. AJR Am J Roentgenol. 2001;177(6):1325-32. doi: 10.2214/ajr.177.6.1771325.
  67. Low RN, Francis IR, Politoske D, Bennett M. Crohn's disease evaluation: comparison of contrast-enhanced MR imaging and single-phase helical CT scanning. J Magn Reson Imaging. 2000;11(2):127-35. doi: 10.1002/(SICI)1522-2586(200002)11:2<127::AID-JMRI8>3.0.CO;2-G.
  68. Van Assche G, Vanbeckevoort D, Bielen D, Coremans G, Aerden I, Noman M, D'Hoo-re A, Penninckx F, Marchal G, Cornillie F, Rut-geerts P. Magnetic resonance imaging of the effects of infliximab on perianal fistulizing Crohn's disease. Am J Gastroenterol. 2003;98(2):332-9. doi: 10.1111/j.1572-0241.2003.07241.x.
  69. Ajaj WM, Lauenstein TC, Pelster G, Gerken G, Ruehm SG, Debatin JF, Goehde SC. Magnetic resonance colonography for the detection of inflammatory diseases of the large bowel: quantifying the inflammatory activity. Gut. 2005;54(2):257-63. doi: 10.1136/gut.2003.037085.
  70. Langhorst J, Kuhle CA, Ajaj W, Nufer M, Barkhau-sen J, Michalsen A, Dobos GJ, Lauenstein TC. MR colonography without bowel purgation for the assessment of inflammatory bowel diseases: diagnostic accuracy and patient acceptance. Inflamm Bowel Dis. 2007;13(8):1001-8. doi: 10.1002/ibd.20140.
  71. Schreyer AG, Rath HC, Kikinis R, Volk M, Scholmerich J, Feuerbach S, Rogler G, Seitz J, Herfarth H. Comparison of magnetic resonance imaging colonography with conventional colonoscopy for the assessment of intestinal inflammation in patients with inflammatory bowel disease: a feasibility study. Gut. 2005;54(2):250-6. doi: 10.1136/gut.2003.037390.
  72. Schreyer AG, Golder S, Scheibl K, Volk M, Len-hart M, Timmer A, Scholmerich J, Feuerbach S, Rogler G, Herfarth H, Seitz J. Dark lumen magnetic resonance enteroclysis in combination with MRI colonography for whole bowel assessment in patients with Crohn's disease: first clinical experience. Inflamm Bowel Dis. 2005;11(4):388-94.
  73. Narin B, Ajaj W, Gohde S, Langhorst J, Akgoz H, Gerken G, Ruhm SG, Lauenstein TC. Combined small and large bowel MR imaging in patients with Crohn's disease: a feasibility study. Eur Radiol. 2004;14(9):1535-42. doi: 10.1007/s00330-004-2364-7.
  74. Van Weyenberg SJ, Bouman K, Jacobs MA, Hal-loran BP, Van der Peet DL, Mulder CJ, Van Kui-jk C, Van Waesberghe JH. Comparison of MR enteroclysis with video capsule endoscopy in the investigation of small-intestinal disease. Abdom Imaging. 2013;38(1):42-51. doi: 10.1007/s00261-012-9892-4.
  75. Darbari A, Sena L, Argani P, Oliva-Hemker JM, Thompson R, Cuffari C. Gadolinium-enhanced magnetic resonance imaging: a useful radiological tool in diagnosing pediatric IBD. In-flamm Bowel Dis. 2004;10(2):67-72.
  76. Халиф ИЛ. Болезнь Крона. Что нужно знать клиницисту. Consilium Medicum. Гастроэнтерология. 2008;(2):46-9.

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