Rath Timo, Tontini Gian Eugenio, Neurath Markus F, Neumann Helmut
Timo Rath, Gian Eugenio Tontini, Markus F Neurath, Helmut Neumann, Department of Medicine 1, Division of Gastroenterology, University Hospital Erlangen, 91054 Erlangen, Germany.
World J Gastroenterol. 2015 Oct 28;21(40):11260-72. doi: 10.3748/wjg.v21.i40.11260.
Inflammatory bowel diseases (IBD) comprise the two major entities Crohn's disease and ulcerative colitis and endoscopic imaging of the gastrointestinal tract has always been an integral and central part in the management of IBD patients. Within the recent years, mucosal healing emerged as a key treatment goal in IBD that substantially decides about the clinical outcome of IBD patients, thereby demanding for a precise, timely and detailed endoscopic assessment of the mucosal inflammation associated with IBD. Further, molecular imaging has tremendously expanded the clinical utility and applications of modern endoscopy, now encompassing not only diagnosis, surveillance, and treatment but also the prediction of individual therapy response. Within this review we describe novel endoscopic approaches and advanced endoscopic imaging methods for the diagnosis, treatment and surveillance of IBD patients. We begin by providing an overview over novel and advanced imaging techniques such as magnification endoscopy and dye-based and dye-less chromoendoscopy, endomicroscopy and endocytoscopy. We then describe how these techniques can be utilized for the precise and ultrastructural assessment of mucosal inflammation and dysplasia development associated with IBD and outline how they have enabled the endoscopist to gain insight onto the cellular level in real-time. Finally, we provide an outlook on how molecular imaging has rapidly evolved in the recent past and can be used to make individual predictions about the therapeutic response towards biological treatment.
炎症性肠病（IBD）包括两大主要类型，即克罗恩病和溃疡性结肠炎，胃肠道的内镜成像一直是IBD患者管理中不可或缺的核心部分。近年来，黏膜愈合已成为IBD的关键治疗目标，这在很大程度上决定了IBD患者的临床结局，因此需要对与IBD相关的黏膜炎症进行精确、及时且详细的内镜评估。此外，分子成像极大地扩展了现代内镜的临床应用范围，如今不仅涵盖诊断、监测和治疗，还包括对个体治疗反应的预测。在本综述中，我们描述了用于IBD患者诊断、治疗和监测的新型内镜方法及先进的内镜成像技术。我们首先概述新型和先进的成像技术，如放大内镜、基于染料和无染料的染色内镜、内镜显微镜检查和内镜细胞检查。然后我们描述这些技术如何用于对与IBD相关的黏膜炎症和发育异常进行精确和超微结构评估，并概述它们如何使内镜医师能够实时深入了解细胞水平的情况。最后，我们展望分子成像在最近几年是如何迅速发展的，以及如何用于对生物治疗的个体治疗反应进行预测。
