Cicerone Clelia, D'Amico Ferdinando, Allocca Mariangela, Zilli Alessandra, Parigi Tommaso Lorenzo, Danese Silvio, Furfaro Federica
Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, 20132 Milan, Italy.
Department of Gastroenterology and Endoscopy, Vita-Salute San Raffaele University, 20132 Milan, Italy.
Diagnostics (Basel). 2024 Jul 16;14(14):1530. doi: 10.3390/diagnostics14141530.
Chronic inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, present diagnostic challenges due to their complex and heterogeneous nature. While histology remains fundamental for accurate diagnosis, a multidisciplinary approach incorporating clinical, endoscopic, and imaging modalities is increasingly recognized as essential for comprehensive evaluation. This article delves into the importance of integrating various diagnostic techniques in the assessment of IBD. Colonoscopy and histology, with its ability to directly visualize the intestinal mucosa, play a central role in the diagnostic process. However, histological analysis alone may not suffice, necessitating the inclusion of advanced imaging techniques, such as magnetic resonance enterography (MRE), computed tomography enterography (CTE), and intestinal ultrasound (IUS). These techniques provide valuable insights into the disease's extent, severity, and complications, and should be used in conjunction with biochemical parameters. These modalities complement traditional endoscopic and histological findings, offering a more holistic understanding of the disease process. A multidisciplinary approach that incorporates clinical, endoscopic, histological, serological, and imaging assessments enables clinicians to achieve a more accurate and timely diagnosis of IBD. Moreover, this integrated approach facilitates personalized treatment strategies tailored to individual patient needs, ultimately improving clinical outcomes and quality of life for those affected by chronic inflammatory bowel diseases.
诸如克罗恩病和溃疡性结肠炎等慢性炎症性肠病，因其复杂且异质性的本质而带来诊断挑战。虽然组织学对于准确诊断仍然至关重要，但越来越多的人认识到，采用包含临床、内镜和影像学方法的多学科方法对于全面评估至关重要。本文深入探讨了在炎症性肠病评估中整合各种诊断技术的重要性。结肠镜检查和组织学检查能够直接观察肠道黏膜，在诊断过程中发挥核心作用。然而，仅靠组织学分析可能并不够，还需要纳入先进的成像技术，如磁共振肠造影（MRE）、计算机断层扫描肠造影（CTE）和肠道超声（IUS）。这些技术能提供有关疾病范围、严重程度和并发症的宝贵信息，应与生化参数结合使用。这些方法补充了传统的内镜和组织学检查结果，能更全面地了解疾病进程。采用包含临床、内镜、组织学、血清学和影像学评估的多学科方法，使临床医生能够更准确、及时地诊断炎症性肠病。此外，这种综合方法有助于制定针对个体患者需求的个性化治疗策略，最终改善慢性炎症性肠病患者的临床结局和生活质量。
