Korean J Intern Med.  2015 May;30(3):271-278. 10.3904/kjim.2015.30.3.271.

Recent trends in diagnostic techniques for inflammatory bowel disease

• Naganuma M
• Hosoe N
• Kanai T
• Ogata H

• KMID: 2160699
• DOI: http://doi.org/10.3904/kjim.2015.30.3.271

Abstract

Although ileocolonoscopy is the gold standard for diagnosis of inflammatory bowel disease and is useful for assessing the disease severity in the colon and terminal ileum, several alternative diagnostic techniques have been developed recently. For ulcerative colitis (UC), magnification colonoscopy, endocytoscopy, and confocal laser endomicroscopy enable assessment of histological inflammation without the need for biopsy. Capsule endoscopy is useful for detection of small intestinal and colonic lesions in both female and male patients. For UC, capsule endoscopy may be useful for evaluating colonic inflammation in patients with a previous poor colonoscopy experience, while it should be used only in Crohn's disease (CD) patients with unexplained symptoms when other examinations are negative. Magnetic resonance enterography (MRE) is particularly useful for detecting transmural inflammation, stenosis, and extraintestinal lesions, including abscesses and fistulas. MRE is also useful when evaluating small and large intestinal lesions, even in cases with severe strictures in which full evaluation of the small bowel would be virtually impossible using other devices. Therefore, the appropriate diagnostic devices for detecting CD lesions in the small and large intestine should be used.

Keyword

Colitis, ulcerative; Crohn disease; Magnification colonoscopy; Capsule endoscopy; Magnetic resonance enterography

MeSH Terms

Colitis, Ulcerative/*diagnosis
Crohn Disease/*diagnosis
Cytodiagnosis/trends
Diagnostic Imaging/*trends
Endoscopy, Gastrointestinal/*trends
Humans
Magnetic Resonance Imaging/trends
Microscopy, Confocal/trends
Predictive Value of Tests
Prognosis
Severity of Illness Index