Imaging in discriminating intestinal tuberculosis and Crohn's disease: past, present and the future

• Published in: Expert review of gastroenterology & hepatology Vol. 13; no. 10; p. 995
• Main Authors: Goyal, Pradeep, Shah, Jimil, Gupta, Sonali, Gupta, Pankaj, Sharma, Vishal
• Format: Journal Article
• Language: English
• Published: England 03.10.2019
• Subjects: Contrast Media - administration & dosage; Crohn Disease - diagnostic imaging; Diagnosis, Differential; Humans; Intestines - diagnostic imaging; Intestines - microbiology; Magnetic Resonance Imaging; Predictive Value of Tests; Prognosis; Reproducibility of Results; Tomography, X-Ray Computed; Tuberculosis, Gastrointestinal - diagnostic imaging; Tuberculosis, Gastrointestinal - microbiology; Ultrasonography; gastrointestinal; Computed tomography; serology; tuberculosis; stricture; colonoscopy; response to therapy
• ISSN: 1747-4132
• DOI: 10.1080/17474124.2019.1673730

: Intestinal tuberculosis (ITB) and Crohn's disease (CD) have similar clinical presentation, but require different treatment approaches. Despite advances in various endoscopic, imaging, microbiological, and histological techniques, the differentiation of these two entities is often difficult. Newer radiological and image acquisition modalities have now become indispensable tools for evaluation of these two diseases. : This review summarizes the currently available literature on various radiological investigations to differentiate ITB from CD. This review also enumerates the newer modalities in image acquisition techniques and their potential role for differentiating these two diseases. At present abdominal computed tomography (CT) scan is used as a first line investigation for differentiating ITB from CD. Magnetic resonance imaging (MRI) is preferred in pediatric patients and for follow-up studies. : Role of newer modalities like contrast enhanced abdominal ultrasound, perfusion CT, advanced MRI and positron emission tomography (PET) is evolving and requires further exploration. Till further robust studies are available, differentiation between ITB and CD requires use of a combination of clinical, endoscopic, serological, histological, and radiological parameters rather than relying on a single test.