Radiological imaging

In a further attempt to distinguish between the various forms of pediatric IBD, 99m-technetium white cell scans and magnetic resonance imaging have been evaluated in children with indeterminate colitis, ulcerative colitis and Crohn's disease.18-20 The technetium scan had a sensitivity of only 76% compared with colonoscopy and biopsy.19 Others found that conventional magnetic resonance imaging had a low sensitivity (40%) for detecting Crohn's disease and did not correlate with the severity of inflammation.20 However, gadolinium-enhanced magnetic resonance imaging in combination with oral polyethylene glycol (PEG) solution (used to distend the small bowel) may be more discriminating.21 With the latter technique, increased wall thickness was noted in 26/26 children with Crohn's disease while those with indeterminate colitis and ulcerative colitis showed mild parietal contrast enhancement but not bowel wall thickening. Further confirmation of these observations is needed.

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