Schmidt Stefan Andreas, Beer Meinrad, Vogele Daniel
Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.
Radiologie (Heidelb). 2023 Jun;63(6):435-440. doi: 10.1007/s00117-023-01139-2. Epub 2023 Apr 4.
CLINICAL/METHODICAL ISSUE: Radiological procedures play a crucial role in the diagnosis of small bowel disease. Due to a broad and quite nonspecific spectrum of symptoms, clinical evaluation is often difficult, and endoscopic procedures require significant manpower, are time-consuming and expensive. In contrast, radiologic imaging can provide important information about morphologic and functional variations of the small bowel and help to identify various disease entities, such as inflammation, tumors, vascular problems, and obstruction.
The most common radiological modalities in small bowel diagnostics include ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), and fluoroscopy. Each of these modalities has its own advantages and limitations, and the choice of imaging modality depends on clinical symptoms and suspected diagnosis in addition to availability.
In recent years, significant progress has been made, especially in cross-sectional imaging modalities, as a result of new and further technical developments.
These range from increasing detail resolution to functional and molecular imaging techniques that go far beyond simple morphology. In addition, information technology (IT) applications, which include artificial intelligence and radiomics, are assuming an increasing role.
Many of the methods mentioned are still in early stages and need to be further developed for daily practice, but some have already found their way into clinical routine.
The aim of this work is to provide a review of the most important disease entities of the small intestine, including new and innovative diagnostic approaches.
临床/方法学问题:放射学检查在小肠疾病的诊断中起着至关重要的作用。由于小肠疾病症状范围广泛且相当不具特异性,临床评估往往困难,而内镜检查需要大量人力、耗时且费用高昂。相比之下,放射学成像可以提供有关小肠形态和功能变化的重要信息,并有助于识别各种疾病实体,如炎症、肿瘤、血管问题和梗阻。
小肠诊断中最常见的放射学检查方法包括超声(US)、计算机断层扫描(CT)、磁共振成像(MRI)和荧光透视检查。这些检查方法各有优缺点,除了可及性外,成像检查方法的选择还取决于临床症状和疑似诊断。
近年来,由于新的和进一步的技术发展,尤其是在横断面成像检查方法方面取得了重大进展。
这些进展涵盖从提高细节分辨率到远远超越简单形态学的功能和分子成像技术。此外,包括人工智能和放射组学在内的信息技术(IT)应用正发挥着越来越重要的作用。
上述许多方法仍处于早期阶段,需要进一步发展以应用于日常实践,但有些方法已经进入临床常规应用。
这项工作的目的是对小肠最重要的疾病实体进行综述,包括新的和创新的诊断方法。