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《计算机断层扫描和磁共振肠造影术评估、解读和应用于小肠克罗恩病患者的共识推荐》

Consensus Recommendations for Evaluation, Interpretation, and Utilization of Computed Tomography and Magnetic Resonance Enterography in Patients With Small Bowel Crohn's Disease.

机构信息

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.

Department of Gastroenterology, University of Florida, Gainesville, Florida.

出版信息

Gastroenterology. 2018 Mar;154(4):1172-1194. doi: 10.1053/j.gastro.2017.11.274. Epub 2018 Jan 10.

Abstract

Computed tomography and magnetic resonance enterography have become routine small bowel imaging tests to evaluate patients with established or suspected Crohn's disease, but the interpretation and use of these imaging modalities can vary widely. A shared understanding of imaging findings, nomenclature, and utilization will improve the utility of these imaging techniques to guide treatment options, as well as assess for treatment response and complications. Representatives from the Society of Abdominal Radiology Crohn's Disease-Focused Panel, the Society of Pediatric Radiology, the American Gastroenterological Association, and other experts, systematically evaluated evidence for imaging findings associated with small bowel Crohn's disease enteric inflammation and established recommendations for the evaluation, interpretation, and use of computed tomography and magnetic resonance enterography in small bowel Crohn's disease. This work makes recommendations for imaging findings that indicate small bowel Crohn's disease, how inflammatory small bowel Crohn's disease and its complications should be described, elucidates potential extra-enteric findings that may be seen at imaging, and recommends that cross-sectional enterography should be performed at diagnosis of Crohn's disease and considered for small bowel Crohn's disease monitoring paradigms. A useful morphologic construct describing how imaging findings evolve with disease progression and response is described, and standard impressions for radiologic reports that convey meaningful information to gastroenterologists and surgeons are presented.

摘要

计算机断层扫描和磁共振肠造影已成为评估确诊或疑似克罗恩病患者的常规小肠成像检查手段,但这些成像方式的解读和应用可能存在很大差异。对成像结果、命名和应用的共同理解将提高这些成像技术的实用性,以指导治疗方案,并评估治疗反应和并发症。来自腹部放射学会克罗恩病重点小组、儿科放射学会、美国胃肠病学会和其他专家的代表,系统地评估了与小肠克罗恩病肠内炎症相关的成像结果的证据,并为小肠克罗恩病的计算机断层扫描和磁共振肠造影的评估、解读和应用建立了推荐意见。这项工作提出了用于指示小肠克罗恩病的成像结果的建议,描述了炎症性小肠克罗恩病及其并发症的方法,阐明了在影像学检查中可能出现的潜在肠外表现,并建议在克罗恩病诊断时进行横断面肠造影,并考虑将其用于小肠克罗恩病的监测方案。还描述了一个有用的形态学构建,用于描述成像结果如何随疾病进展和反应而演变,并提出了传达给胃肠病学家和外科医生有意义信息的放射报告的标准印象。

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