What are the limitations of imaging in the diagnosis of ulcerative colitis (UC)?

Updated: Feb 23, 2019
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

All imaging techniques lack specificity. Mucosal ulceration depicted on barium studies is nonspecific and is encountered in a variety of colitides. In severe cases, barium enema may precipitate toxic megacolon. Generally, barium enemas may be performed safely only in mild cases. Thickening of the bowel wall, as seen on cross-sectional imaging (CT, MRI, and US), is a nonspecific finding seen in a variety of bowel conditions besides IBD. Increased radionuclide focal activity may be related to a variety of physiologic and pathologic conditions unrelated to ulcerative colitis. Motion artifacts may interfere with cross-sectional imaging. Although this is not a major problem with modern scanners, some investigators still use a hypotonic agent to decrease bowel peristalsis.


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