Centre for Medical Imaging, University College London, London, UK.
Radiology Department, Ghent University Hospital, Ghent, Belgium.
J Crohns Colitis. 2024 Sep 3;18(9):1450-1463. doi: 10.1093/ecco-jcc/jjae042.
Magnetic resonance enterography [MRE] and intestinal ultrasound [IUS] have developed rapidly in the past few decades, emerging as the primary non-invasive options for both diagnosing and monitoring Crohn's disease [CD]. In this review, we evaluate the pertinent data relating to the use of MRE and IUS in CD. We summarise the key imaging features of CD activity, highlight their increasing role in both the clinical and the research settings, and discuss how these modalities fit within the diagnostic pathway. We discuss how they can be used to assess disease activity and treatment responsiveness, including the emergence of activity scores for standardised reporting. Additionally, we address areas of controversy such as the use of contrast agents, the role of diffusion-weighted imaging, and point-of-care ultrasound. We also highlight exciting new developments, including the applications of artificial intelligence. Finally, we provide suggestions for future research priorities.
磁共振肠道成像[MRE]和肠内超声[IUS]在过去几十年中迅速发展,成为诊断和监测克罗恩病[CD]的主要非侵入性选择。在这篇综述中,我们评估了与 MRE 和 IUS 在 CD 中的应用相关的数据。我们总结了 CD 活动的关键影像学特征,强调了它们在临床和研究环境中的作用不断增加,并讨论了这些方式如何适应诊断途径。我们讨论了如何使用它们来评估疾病活动和治疗反应,包括用于标准化报告的活动评分的出现。此外,我们还解决了一些争议领域,如对比剂的使用、扩散加权成像的作用以及即时超声检查。我们还强调了令人兴奋的新发展,包括人工智能的应用。最后,我们为未来的研究重点提供了建议。