Editing Crohn's disease (section)

=== Pediatrics considerations ===
Imaging in pediatric Crohn's disease requires careful consideration to minimize radiation exposure while ensuring accurate diagnosis and monitoring. Magnetic Resonance Enterography (MRE) is favored over Computed Tomography Enterography (CTE) due to its lack of ionizing radiation and superior soft tissue contrast. MRE effectively assesses bowel wall thickening, inflammation, and complications such as strictures or fistulas. However, it demands longer scan times and patient cooperation, which can be challenging for younger children.<ref>{{Cite journal |last=Casciani |first=Emanuele |date=2014 |title=Imaging of the small bowel: Crohn's disease in paediatric patients |journal=World Journal of Radiology |volume=6 |issue=6 |pages=313–328 |doi=10.4329/wjr.v6.i6.313 |doi-access=free | title-link = doi |issn=1949-8470 |pmc=4072817 |pmid=24976933}}</ref>

Ultrasound (US), particularly contrast-enhanced ultrasound, serves as a valuable, radiation-free alternative for evaluating bowel wall thickness, vascularity, and inflammatory changes. It is especially useful for initial assessments and ongoing disease monitoring, though its effectiveness can be operator-dependent.<ref>{{Cite journal |last=Chiorean |first=Liliana |date=2015 |title=Ultrasonographic imaging of inflammatory bowel disease in pediatric patients |journal=World Journal of Gastroenterology |volume=21 |issue=17 |pages=5231–5241 |doi=10.3748/wjg.v21.i17.5231 |doi-access=free | title-link = doi |issn=1007-9327 |pmc=4419063 |pmid=25954096}}</ref>

In urgent situations where rapid imaging is necessary to evaluate severe disease complications, such as bowel perforation or abscess formation, CTE may be utilized despite its associated radiation exposure.<ref>{{Cite journal |last1=Moore |first1=Michael M. |last2=Gee |first2=Michael S. |last3=Iyer |first3=Ramesh S. |last4=Chan |first4=Sherwin S. |last5=Ayers |first5=Travis D. |last6=Bardo |first6=Dianna M.E. |last7=Chandra |first7=Tushar |last8=Cooper |first8=Matthew L. |last9=Dotson |first9=Jennifer L. |last10=Gadepalli |first10=Samir K. |last11=Gill |first11=Anne E. |last12=Levin |first12=Terry L. |last13=Nadel |first13=Helen R. |last14=Schooler |first14=Gary R. |last15=Shet |first15=Narendra S. |date=May 2022 |title=ACR Appropriateness Criteria® Crohn Disease-Child |url=https://linkinghub.elsevier.com/retrieve/pii/S1546144022001909 |journal=Journal of the American College of Radiology |volume=19 |issue=5 |pages=S19–S36 |doi=10.1016/j.jacr.2022.02.020|pmid=35550801 }}</ref>

Regular imaging follow-ups should be guided by clinical symptoms and biomarkers to minimize unnecessary scans.<ref>{{Cite journal |last1=Gee |first1=Michael S. |last2=Nimkin |first2=Katherine |last3=Hsu |first3=Maylee |last4=Israel |first4=Esther J. |last5=Biller |first5=Jeffrey A. |last6=Katz |first6=Aubrey J. |last7=Mino-Kenudson |first7=Mari |last8=Harisinghani |first8=Mukesh G. |date=July 2011 |title=Prospective Evaluation of MR Enterography as the Primary Imaging Modality for Pediatric Crohn Disease Assessment |journal=American Journal of Roentgenology |volume=197 |issue=1 |pages=224–231 |doi=10.2214/AJR.10.5970 |issn=0361-803X |pmc=3711021 |pmid=21701034}}</ref> Emerging imaging techniques continue to improve the safety and efficacy of pediatric Crohn's disease evaluation.