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炎症性肠病评估的影像学技术:ECCO 和 ESGAR 联合循证共识指南。

Imaging techniques for assessment of inflammatory bowel disease: joint ECCO and ESGAR evidence-based consensus guidelines.

机构信息

Gastroenterology Department, Hospital Clinic Barcelona, CIBERehd, IDIBAPS, Barcelona, Spain.

出版信息

J Crohns Colitis. 2013 Aug;7(7):556-85. doi: 10.1016/j.crohns.2013.02.020. Epub 2013 Apr 11.

Abstract

The management of patients with IBD requires evaluation with objective tools, both at the time of diagnosis and throughout the course of the disease, to determine the location, extension, activity and severity of inflammatory lesions, as well as, the potential existence of complications. Whereas endoscopy is a well-established and uniformly performed diagnostic examination, the implementation of radiologic techniques for assessment of IBD is still heterogeneous; variations in technical aspects and the degrees of experience and preferences exist across countries in Europe. ECCO and ESGAR scientific societies jointly elaborated a consensus to establish standards for imaging in IBD using magnetic resonance imaging, computed tomography, ultrasonography, and including also other radiologic procedures such as conventional radiology or nuclear medicine examinations for different clinical situations that include general principles, upper GI tract, colon and rectum, perineum, liver and biliary tract, emergency situation, and the postoperative setting. The statements and general recommendations of this consensus are based on the highest level of evidence available, but significant gaps remain in certain areas such as the comparison of diagnostic accuracy between different techniques, the value for therapeutic monitoring, and the prognostic implications of particular findings.

摘要

IBD 患者的管理需要使用客观工具进行评估,无论是在诊断时还是在疾病过程中,以确定炎症病变的位置、范围、活动度和严重程度,以及潜在的并发症。内镜检查是一种成熟且普遍执行的诊断检查,而放射技术在 IBD 评估中的应用仍存在异质性;在欧洲各国,技术方面的差异以及经验和偏好程度存在差异。ECCO 和 ESGAR 科学协会共同制定了一项共识,旨在使用磁共振成像、计算机断层扫描、超声检查以及包括常规放射学或核医学检查等其他放射学程序来为不同的临床情况制定 IBD 成像标准,这些情况包括一般原则、上消化道、结肠和直肠、会阴、肝脏和胆道、急症和术后环境。本共识的陈述和一般建议基于现有的最高证据水平,但在某些领域仍存在显著差距,例如不同技术之间的诊断准确性比较、治疗监测的价值以及特定发现的预后意义。

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