Advances in Diagnostic Imaging in Pediatric Gastroenterology

The purpose is to provide a review of cross-sectional imaging updates in the assessment of gastrointestinal diseases, relevant to clinical practice and research.

New magnetic resonance imaging contrast agents (Eovist) are taken up by hepatocytes and excreted via the biliary tree. As such, a lesion will retain contrast only if hepatocytes are present, which aids in refining the differential diagnosis. Magnetic resonance enterography is a method for non-invasively diagnosing and following various GI conditions, predominantly inflammatory bowel disease. Contrast-enhanced ultrasound uses gas-filled microbubbles providing superb temporal resolution most notably in the arterial phase, which aids in differentiating lesions. Elastography is a new technique which assesses stiffness of liver for evaluating fibrosis. These new techniques provide more accurate diagnoses and information, often limiting ionizing radiation exposure from other modalities. While ultrasound will still remain the initial imaging modality, familiarity with these other options is valuable for appropriate pathology workup.