Szurowska Edyta, Wypych Joanna, Izycka-Swieszewska Ewa
Department of Radiology Medical, University of Gdansk, Debinki St 7, 80-211, Gdansk, Poland.
Abdom Imaging. 2007 Nov;32(6):705-18. doi: 10.1007/s00261-007-9188-2. Epub 2007 Mar 3.
Crohn's disease is a chronic, transmural inflammatory process of the gastrointestinal tract. It often affects the colon with the perianal area. The most common intestinal manifestations include external and/or internal fistulas and abscesses. Assessment of the activity of perianal fistulas in the course of Crohn's disease seems to be an important factor influencing therapeutic approach. Fistula's activity is evaluated by such methods as magnetic resonance imaging, anal ultrasound and examination under anaesthesia. Usefulness of imaging methods in the diagnosis of fistulas still remains to be defined.MRI is used to present a wide spectrum of perianal fistulazing Crohn's disease. Additionally, it is an important instrument revealing location, extent and severity of inflammation. It is also very helpful to detect clinically silent sepsis related to small, local inflammation. The most common method used in MR imaging to assess topography of a fistula's track, is Parks' classification.Clinical indications to MRI may include follow-up studies of a diagnosed disease, classification of fistulas' subtypes in the course of Crohn's disease, determination of the extent of fistulas' tracts and spread of an inflammatory process what can guide surgical procedures.
克罗恩病是一种胃肠道的慢性透壁性炎症过程。它常累及结肠及肛周区域。最常见的肠道表现包括外部和/或内部瘘管及脓肿。评估克罗恩病过程中肛周瘘管的活动情况似乎是影响治疗方法的一个重要因素。瘘管的活动情况通过磁共振成像、肛门超声及麻醉下检查等方法进行评估。成像方法在瘘管诊断中的实用性仍有待确定。磁共振成像用于呈现广泛的肛周瘘管性克罗恩病。此外，它是揭示炎症部位、范围及严重程度的重要手段。对于检测与微小局部炎症相关的临床无症状脓毒症也非常有帮助。磁共振成像中评估瘘管路径形态最常用的方法是帕克斯分类法。磁共振成像的临床适应证可能包括对已确诊疾病的随访研究、克罗恩病过程中瘘管亚型的分类、确定瘘管路径的范围及炎症过程的扩散情况，这可为外科手术提供指导。
