Journal of medical imaging and radiation sciences · 2025
Evaluating the utility of different radiographic imaging modalities for assessing intussusception, Crohn's Disease and adenocarcinoma to the small bowel: A systematic review.
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Cassimatis Caitlin, O'Reilly Peter, Taba Amir Tavakoli
Аннотация
INTRODUCTION: Radiography is a crucial alternative in diagnosing small bowel pathologies due to the challenges of endoscopy. This review evaluates intussusception, Crohn's Disease, and small bowel adenocarcinoma to compare modalities across age groups and provide optimal imaging recommendations.
METHODS: A systematic search was performed in Embase, Medline, Scopus and Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The review included studies from the past five years comparing modalities for the diagnosis of intussusception, Crohn's Disease, or small bowel adenocarcinoma. The Critical Appraisal Skills Programme tool was used for quality assessment. Data extraction was completed using a standardised template, and a thematic approach for narrative synthesis was performed.
RESULTS: Thirty-five studies were included, highlighting a higher diagnostic accuracy of ultrasound over radiography in pediatric intussusception. In adults, computed tomography (CT) was the only viable imaging modality, and adenocarcinoma was the most common malignant underlying cause of obstruction. Literature on adenocarcinoma was limited, with no analysis beyond standard cross-sectional modalities. In Crohn's Disease, magnetic resonance imaging (MRI) was considered advantageous for young people. CT techniques were emerging in terms of prominence for the monitoring of Crohn's Disease activity.
CONCLUSION: Ultrasound is recommended for pediatric intussusception diagnosis, with radiographs favoured for predicting surgical outcomes. For Crohn's Disease, the optimal use of CT and MRI depends upon the phase of disease at the time of imaging. Given the late diagnosis of small bowel adenocarcinoma, further research into an optimised diagnostic pathway is necessary. Novel small bowel imaging techniques emerging in ultrasound, CT and MRI demonstrate potential diagnostic benefits for clinical use due to increased ability to differentiate between pathologies and reduced radiation doses.
METHODS: A systematic search was performed in Embase, Medline, Scopus and Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The review included studies from the past five years comparing modalities for the diagnosis of intussusception, Crohn's Disease, or small bowel adenocarcinoma. The Critical Appraisal Skills Programme tool was used for quality assessment. Data extraction was completed using a standardised template, and a thematic approach for narrative synthesis was performed.
RESULTS: Thirty-five studies were included, highlighting a higher diagnostic accuracy of ultrasound over radiography in pediatric intussusception. In adults, computed tomography (CT) was the only viable imaging modality, and adenocarcinoma was the most common malignant underlying cause of obstruction. Literature on adenocarcinoma was limited, with no analysis beyond standard cross-sectional modalities. In Crohn's Disease, magnetic resonance imaging (MRI) was considered advantageous for young people. CT techniques were emerging in terms of prominence for the monitoring of Crohn's Disease activity.
CONCLUSION: Ultrasound is recommended for pediatric intussusception diagnosis, with radiographs favoured for predicting surgical outcomes. For Crohn's Disease, the optimal use of CT and MRI depends upon the phase of disease at the time of imaging. Given the late diagnosis of small bowel adenocarcinoma, further research into an optimised diagnostic pathway is necessary. Novel small bowel imaging techniques emerging in ultrasound, CT and MRI demonstrate potential diagnostic benefits for clinical use due to increased ability to differentiate between pathologies and reduced radiation doses.