Kuczyńska Maryla, Zbroja Monika, Drelich-Zbroja Anna
Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, 20-059 Lublin, Poland.
Department of Pediatric Radiology, Medical University of Lublin, 20-059 Lublin, Poland.
Diagnostics (Basel). 2024 Oct 16;14(20):2299. doi: 10.3390/diagnostics14202299.
Crohn's disease (CD) is a complex systemic entity, characterized by the progressive and relapsing inflammatory involvement of any part of the gastrointestinal tract. Its clinical pattern may be categorized as penetrating, stricturing or non-penetrating non-stricturing.
In this paper, we performed a database search (Pubmed, MEDLINE, Mendeley) using combinations of the queries "crohn", "stricture" and "elastography" up to 19 June 2024 to summarize current knowledge regarding the diagnostic utility of ultrasound (US) and magnetic resonance (MR) elastography techniques in the evaluation of stricturing CD by means of an assessment of the transmural intestinal fibrosis. We decided to include papers published since 1 January 2017 for further evaluation ( = 24).
Despite growing collective and original data regarding numerous applications of mostly ultrasound elastography (quantification of fibrosis, distinguishing inflammatory from predominantly fibrotic strictures, assessment of treatment response, predicting disease progression) constantly emerging, to date, we are still lacking a uniformization in both cut-off values and principles of measurements, i.e., reference tissue in strain elastography (mesenteric fat, abdominal muscles, unaffected bowel segment), units, not to mention subtle differences in technical background of SWE techniques utilized by different vendors. All these factors imply that ultrasound elastography techniques are hardly translatable throughout different medical centers and practitioners, largely depending on the local experience.
Nonetheless, the existing medical evidence is promising, especially in terms of possible longitudinal comparative studies (follow-up) of patients in the course of the disease, which seems to be of particular interest in children (lack of radiation, less invasive contrast media) and terminal ileal disease (easily accessible).
克罗恩病（CD）是一种复杂的全身性疾病，其特征是胃肠道任何部位进行性和复发性炎症累及。其临床模式可分为穿透性、狭窄性或非穿透性非狭窄性。
在本文中，我们进行了数据库检索（PubMed、MEDLINE、Mendeley），使用“克罗恩”、“狭窄”和“弹性成像”等关键词组合，截至2024年6月19日，以通过评估透壁肠道纤维化来总结关于超声（US）和磁共振（MR）弹性成像技术在评估狭窄性CD中的诊断效用的当前知识。我们决定纳入自2017年1月1日以来发表的论文进行进一步评估（n = 24）。
尽管关于大多数超声弹性成像的众多应用（纤维化定量、区分炎症性狭窄与主要纤维化狭窄、评估治疗反应、预测疾病进展）的集体和原始数据不断涌现，但迄今为止，我们在临界值和测量原则方面仍缺乏统一标准，即应变弹性成像中的参考组织（肠系膜脂肪、腹部肌肉、未受影响的肠段）、单位，更不用说不同供应商使用的剪切波弹性成像（SWE）技术在技术背景上的细微差异了。所有这些因素意味着超声弹性成像技术在不同医疗中心和从业者之间很难通用，很大程度上取决于当地经验。
尽管如此，现有的医学证据很有前景，特别是在疾病过程中对患者进行可能的纵向比较研究（随访）方面，这似乎对儿童（无辐射、侵入性较小的造影剂）和末端回肠疾病（易于检查）特别有意义。
