Bruining David H, Loftus Edward V
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street Southwest, Rochester, MN 55905, USA.
Curr Gastroenterol Rep. 2007 Dec;9(6):489-96. doi: 10.1007/s11894-007-0065-5.
Advances in serologic markers and imaging modalities continue to revolutionize diagnostic approaches to inflammatory bowel disease (IBD). Autoimmune and antimicrobial antibodies demonstrate diagnostic value in those patients with a moderate pretest probability of disease. Emerging data also support the use of antimicrobial antibody levels as a predictive tool for small bowel complications and the need for future surgery. In addition to being a prognostic marker in patients with acute severe colitis, serum C-reactive protein has been shown to correlate with clinical, endoscopic, and radiologic measures of disease activity. Capsule endoscopy and double-balloon endoscopy allow for visualization of the entire small bowel, and double-balloon endoscopy also has the capability to treat lesions. CT enterography is beginning to replace small bowel follow-through because of its high sensitivity and specificity for disease of the small intestine. Both CT and magnetic resonance enterography detect luminal and extraluminal abnormalities, with MRI serving as a safe imaging option in cases of pregnancy and renal insufficiency. These newer modalities add to the armamentarium clinicians can use for evaluation of IBD.
血清学标志物和成像方式的进展继续彻底改变炎症性肠病（IBD）的诊断方法。自身免疫抗体和抗菌抗体在疾病预测试验概率中等的患者中显示出诊断价值。新出现的数据也支持将抗菌抗体水平用作小肠并发症的预测工具以及未来手术需求的预测指标。除了作为急性重症结肠炎患者的预后标志物外，血清C反应蛋白已被证明与疾病活动的临床、内镜和放射学指标相关。胶囊内镜和双气囊内镜可实现对整个小肠的可视化，并且双气囊内镜还具备治疗病变的能力。由于CT小肠造影对小肠疾病具有高敏感性和特异性，它正开始取代小肠钡剂造影。CT和磁共振小肠造影均可检测腔内和腔外异常，在妊娠和肾功能不全的情况下，磁共振成像作为一种安全的成像选择。这些更新的方式增加了临床医生可用于评估IBD的手段。
