Department of Hepatogastroenterology, Hôpital Saint-Louis, Paris, France.
AJR Am J Roentgenol. 2011 Jul;197(1):42-9. doi: 10.2214/AJR.11.6632.
This article will review the performance and limitations of cross-sectional imaging methods to detect and display critical features of Crohn disease (CD)-related bowel damage, including stenosis and penetrating complications (i.e., fistula, abscess). International efforts to incorporate cross-sectional imaging findings along with endoscopic and surgical findings to create a global bowel damage score over the length of the gastrointestinal tract are summarized along with the rationale for these efforts.
The first digestive damage score, the Lémann score, will incorporate surgical history, endoscopic findings, and imaging findings of stenosis and penetrating complications to provide a global assessment of CD-related destruction of the gastrointestinal tract. It is anticipated that the score will permit better understanding of the impact of modern therapeutics on the natural history of CD. Because CT is a technique that involves ionizing radiation and accuracy of ultrasound is highly related to CD location, MRI is proposed as first choice for nonemergent follow-up of CD patients.
本文将回顾各种横断面成像方法在检测和显示克罗恩病（CD）相关肠损伤的关键特征方面的表现和局限性，包括狭窄和穿透性并发症（即瘘管、脓肿）。总结了将横断面成像结果与内镜和手术结果结合起来，在胃肠道全长范围内创建全球肠损伤评分的国际努力，以及这些努力的基本原理。
第一个消化损伤评分，即勒曼评分，将纳入手术史、内镜发现以及狭窄和穿透性并发症的影像学发现，以对 CD 相关胃肠道破坏进行全面评估。预计该评分将有助于更好地了解现代治疗方法对 CD 自然病程的影响。由于 CT 是一种涉及电离辐射的技术，而超声的准确性与 CD 的位置高度相关，因此 MRI 被提议作为 CD 患者非紧急随访的首选方法。
