Ripollés Tomás, Martínez-Pérez María J, Blanc Esther, Delgado Fructuoso, Vizuete José, Paredes José M, Vilar José
Insights Imaging. 2011 Dec;2(6):639-652. doi: 10.1007/s13244-011-0124-1. Epub 2011 Aug 10.
Recent meta-analysis has demonstrated no significant differences in diagnostic accuracy among different imaging techniques (US, MRI and CT) in the evaluation of Crohn's disease (CD). High-resolution bowel ultrasound has emerged as an alternative imaging technique for the diagnosis and follow-up of patients with CD, being as accurate as CT and MR for detecting intramural and extramural extension of the disease. B-Mode US can evaluate the localization and length of the affected intestinal segments and allow identification of transmural complications, stenosis and intestinal obstruction. Doppler techniques are tools that visualize and quantify bowel vascularization. Contrast-enhanced ultrasound (CEUS) is a new technique that involves IV administration of an ultrasound contrast agent with real-time examination, providing an accurate depiction of the bowel wall microvascularization and the perienteric tissues. The introduction of imaging quantification techniques enables an objective quantitative measurement of the enhancement. METHOD AND RESULTS: The article reviews the technique, sonographic findings, advantages and limitations, and clinical applications of contrast-enhanced US in the evaluation of Cohn's disease. Current CEUS applications in CD are: CD activity assessment, evaluation of inflammatory masses, distinguishing phlegmons from abscesses, characterization of stenosis by differentiating fibrosis from inflammation, monitoring the efficacy of drug treatments and improving the detection of disease recurrence. CONCLUSION: CEUS is an emerging technique that is part of the entire sonographic evaluation, with a role in the diagnosis and follow-up of CD, thus improving therapy planning and monitoring of the efficacy of treatment. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13244-011-0124-1) contains supplementary material, which is available to authorized users.
近期的荟萃分析表明，在克罗恩病（CD）评估中，不同成像技术（超声、磁共振成像和计算机断层扫描）的诊断准确性无显著差异。高分辨率肠道超声已成为CD患者诊断和随访的一种替代成像技术，在检测疾病的壁内和壁外扩展方面与CT和磁共振成像一样准确。B型超声可评估受累肠段的定位和长度，并有助于识别透壁并发症、狭窄和肠梗阻。多普勒技术是可视化和量化肠道血管化的工具。超声造影（CEUS）是一种新技术，涉及静脉注射超声造影剂并进行实时检查，可准确描绘肠壁微血管化和肠周组织。成像量化技术的引入能够对增强进行客观定量测量。
本文综述了超声造影在克罗恩病评估中的技术、超声表现、优缺点及临床应用。目前CEUS在CD中的应用包括：CD活动度评估、炎性肿块评估、鉴别蜂窝织炎与脓肿、通过区分纤维化与炎症来表征狭窄、监测药物治疗效果以及提高疾病复发的检测率。
CEUS是一种新兴技术，是整个超声评估的一部分，在CD的诊断和随访中发挥作用，从而改善治疗方案规划和治疗效果监测。
本文的在线版本（doi:https://doi.org/10.1007/s13244-011-0124-1）包含补充材料，授权用户可获取。 （注：原文中doi链接格式有误，补充材料获取部分根据正确格式添加了https:// ，实际翻译时可根据实际正确情况处理）
