Spier B J, Perlman S B, Reichelderfer M
Department of Gastroenterology and Hepatology, University of Wisconsin Hospital and Clinics, Madison, WI, USA.
Q J Nucl Med Mol Imaging. 2009 Feb;53(1):64-71.
Accurate, inexpensive, non-invasive studies in evaluation of inflammatory bowel disease (IBD) would represent a significant advancement in identifying and measuring disease activity. There is new evidence that positron emission tomography (PET) scanning can fulfill many of these criteria. The aim of this review is to report the studies pertaining to the use of PET in IBD and provide an evidence-based approach on how to use PET clinically in IBD. Searching Medline and the Cochrane Database of Clinical Trails on July 18, 2008 identified 12 relevant manuscripts for review. Types of studies of PET in IBD include the incidental identification of IBD during studies performed for other indications, the evaluation of suspected IBD and the assessment of known IBD. PET has been studied in both children and adults and has shown excellent sensitivity for detecting active bowel inflammation, but with poor specificity in some studies. PET alone appears sufficient for the evaluation of ulcerative colitis, but PET/computed tomography provides considerably more information over PET alone in the evaluation of Crohn's disease. Current clinical applications for PET in IBD include its use in the early evaluation of IBD, especially in children who may not tolerate an invasive test such as colonoscopy; and its use in differentiating between a flare of IBD versus the onset of a non-inflammatory process causing similar symptoms in patients with known IBD. Many unanswered questions remain, but PET appears to be a promising tool in the non-invasive evaluation of IBD.
在炎症性肠病（IBD）评估中进行准确、廉价且无创的研究，将在识别和测量疾病活动方面取得重大进展。有新证据表明，正电子发射断层扫描（PET）可满足其中许多标准。本综述的目的是报告有关PET在IBD中应用的研究，并提供关于如何在临床上将PET用于IBD的循证方法。2008年7月18日检索Medline和Cochrane临床对照试验数据库，确定了12篇相关手稿以供综述。PET在IBD中的研究类型包括在为其他适应症进行的研究中偶然发现IBD、评估疑似IBD以及评估已知IBD。PET已在儿童和成人中进行研究，在检测活动性肠道炎症方面显示出极佳的敏感性，但在一些研究中特异性较差。单独使用PET似乎足以评估溃疡性结肠炎，但在评估克罗恩病时，PET/计算机断层扫描比单独使用PET能提供更多信息。PET在IBD中的当前临床应用包括用于IBD的早期评估，特别是在那些可能无法耐受如结肠镜检查等侵入性检查的儿童中；以及用于区分IBD发作与已知IBD患者中引起类似症状的非炎症性过程的发作。许多问题仍未得到解答，但PET似乎是IBD无创评估中一种很有前景的工具。
