| Abstract | Upalne bolesti crijeva (UBC), u koje spadaju ulcerozni kolitis i Crohnova bolest, kronične su bolesti različitih dijelova gastrointestinalnoga trakta. Simptomi kao što mučnina, proljevasta stolica s primjesima krvi,sluzi, bol u trbuhu, visoka temperatua javljaju se u svim dobnim skupinama uz višu incidenciju između 15. i 30. godine. Za razliku od Crohnove bolesti, koja može zahvatiti bilo koji dio gastrointestinalnoga trakta, ulcerozni kolitis zahvaća samo debelo crijevo te rektum. Dijagnoza se utvrđuje kombinacijom kliničke procjene, laboratorijskih, endoskopskih ,patohistoloških i radioloških nalaza. Endoskopske pretrage iako su invazivnije od radioloških još uvijek se koriste jer nam daju mogučnost uzimanja tkiva za patohistološki nalaz. Neminovna je primjena radioloških metoda oslikavanja u vrijeme postavljanja dijagnoze, tijeka bolesti, za određivanje lokalizacije, aktivnosti i težine upalnih promjena. Nativna slika abdomena i konvencionalne radiološke metode kao što su pasaža tankoga crijeva te irigografija zastarjele su tehnike koje nisu dovoljne za potvrđivanje dijagnoze te trebaju biti potkrijepljene različitim dijagnostičkim metodama kao što su ultrazvuk, kompjutorozirana tomografija i magnetska rezonancija. Slojevne metode oslikavanja, odnosno kompjutorozirana tomografija i magnetska rezonancija imaju temeljnu ulogu pri dijagnostici i otkrivanju intramuralnih i ekstramuralnih manifestacija. Kompjuterizirana tomografija široko je dostupna tehnika te zbog svoje visoke specifičnosti, osjetljivosti i brzine izvođenja smatra se metodom izbora u akutnim stanjima za bolesnike UBC. Glavni nedostatak ove metode je preveliko izlaganje zračenju pacijenata koji radi egzacerbacije bolesti su primorani ponavljati radiološke pretrage. Uloga MRI u procjeni upalne bolesti crijeva sve više se primjenjuje u dijagnostici zbog odsutnosti ionizirajućega zračenja i superiornog kontrasta mekoga tkiva. Međutim, nedostatci ove metode su visoka cijena i nedostupnost pretrage, manja prostorna i vremenska rezolucija te nemogućnost snimanja pacijenata s metalnim implatatima i klaustrofobijom. Odgovornost je kliničara da odvagne rizike i koristi u svakom jedinstvenom kliničkom scenariju, uzimajući u obzir stabilnost pacijenta, dostupnost i informacije koje su potrebne. |
| Abstract (english) | Inflammatory bowel diseases (IBD), which include ulcerative colitis and Crohn's disease, are chronic diseases of different parts of the gastrointestinal tract. Symptoms such as nausea, diarrheal stools with admixtures of blood, mucus, abdominal pain, high temperature occur in all age groups with a higher incidence between the ages of 15 and 30. Unlike Crohn's disease, which can affect any part of the gastrointestinal tract, ulcerative colitis affects only the colon and rectum. The correct diagnosis is determined by a combination of clinical assessment, laboratory, endoscopic, pathohistological and radiological findings. Although endoscopic tests are more invasive than radiological ones, they are still used because they allow us to take tissue for pathohistological findings. It is inevitable to use radiological imaging methods at the time of diagnosis, the course of the disease, to determine the localization, activity and severity of inflammatory changes. Native imaging of the abdomen and conventional radiological methods such as small bowel passage and irrigography are outdated techniques that are not sufficient to confirm the diagnosis and should be supported by different diagnostic methods such as ultrasound. Layered imaging methods, i.e. computed tomography and magnetic resonance, play a fundamental role in the diagnosis and detection of intramural and extramural manifestations. Computed tomography is a widely available technique, and due to its high pecificity, sensitivity and speed of execution, it is considered the method of choice in acute conditions for IBD patients. The main disadvantage of this method is the excessive radiation exposure of the patient, who, due to exacerbation of the disease, is forced to repeat radiological examinations. The role of MRI in the assessment of inflammatory bowel disease is increasingly used in diagnostics due to the absence of ionizing radiation and superior soft tissue contrast. However, the disadvantages of this method are the high price and unavailability of the examination, lower spatial and temporal resolution, and the impossibility of imaging patients with metal implants and claustrophobia. It is the clinician's responsibility to weigh the risks and benefits in each unique clinical scenario, taking into account the patient's stability, availability, and the information needed. |
