The best imaging test for you depends on the specific medical questions that need to be answered and if you have other medical conditions that limit the choices. Limiting conditions include allergy to intravenous contrast, kidney disease, pregnancy, or a pacemaker or other metal implant. The best test is the one with the highest likelihood of providing correct information with a low risk of harm. In some situations, the best test involves radiation.

Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) both use a large volume of oral contrast to provide superb visualization of the small bowel to assess for the presence and severity of Crohn’s disease. A head-to-head comparison showed similar accuracy for CTE and MRE in detecting small bowel inflammation [1]. Computed tomography (CT) and magnetic resonance imaging (MRI) without enterography demonstrate complications of Crohn’s disease and ulcerative colitis including bowel obstruction, megacolon, abscesses, and some fistulas. Ultrasound of the small intestine is an alternative to CT and MRI for evaluating small intestinal Crohn’s disease that requires a high level of expertise. Barium studies, either orally or as a barium enema, are sometimes the best method for confirming partial small bowel obstruction. Each of these imaging techniques has advantages and shortcomings.