ASGE Annual GI Advanced Practice Provider Course (Virtual) (Day One) | March 2026-Radiology Studies Case 3- IBD

Radiology Studies Case 3- IBD - Imaging in Work Up and Management

Video Transcription

Video Summary

The speaker reviews how noninvasive imaging complements endoscopy in inflammatory bowel disease (IBD), especially Crohn’s disease, which is transmural and can’t be fully assessed by mucosal visualization alone. They compare intestinal ultrasound (IUS), MR enterography (MRE), and CT enterography (CTE). IUS is radiation-free, real-time, point-of-care in some centers, correlates with outcomes, supports shared decision-making, and may predict surgery risk at diagnosis. MRE provides detailed bowel wall/mesenteric assessment and is strong for fistulas, abscesses, and fibrosis, but is lengthy and requires oral/IV contrast. CTE is widely available and high resolution but involves radiation. The talk emphasizes distinguishing inflammatory vs fibrotic strictures using imaging features (wall thickness, hyperemia, prestenotic dilation) because fibrosis won’t respond to biologics. Case examples highlight integrating symptoms, imaging, labs, and colonoscopy to decide between medical optimization, dilation, or surgery, and stress MRI pelvis as key for perianal Crohn’s/fistula monitoring.

Asset Subtitle

Amy Stewart, CRNP

Keywords

Crohn’s disease noninvasive imaging

intestinal ultrasound (IUS)

MR enterography (MRE)

inflammatory vs fibrotic strictures

perianal Crohn’s MRI pelvis