Younis Muhammad Yasir, Khan Muhammad Usman, Khan Usman, Latif Khan Talal, Mukarram Hassan, Jain Kanav, Ilyas Insha, Jain Wachi
Gastroenterology, Lahore General Hospital, Lahore, PAK.
Gastroenterology, Allama Iqbal Teaching Hospital Dera Ghazi Khan, Dera Ghazi Khan, PAK.
Cureus. 2024 Nov 6;16(11):e73134. doi: 10.7759/cureus.73134. eCollection 2024 Nov.
Inflammatory bowel disease (IBD) encompasses complex gastrointestinal (GI) conditions, primarily Crohn's disease (CD) and ulcerative colitis (UC), requiring precise imaging for effective diagnosis and management of complications. This systematic review aimed to evaluate the current role of imaging modalities in diagnosing IBD and detecting related complications. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed a literature search using text words and controlled vocabulary applying Boolean operators "AND," "OR," with various combinations on databases such as PubMed, Embase, and Cochrane Library. The search targeted open-access articles involving humans, with full-text available, and published in the English Language from 2005 to 2024. The quality of the included studies was assessed using the Cochrane Risk-of-Bias (RoB) checklist. Our search process identified 127 records from Cochrane (39), Embase (29), and PubMed (59). After removing 98 irrelevant records, 29 underwent further screening. Five were excluded as they involved irrelevant problems or outcomes, leaving us with 24 reports with full text, all of which were accessible. Following the eligibility assessment, two more reports were excluded due to inaccessibility, and 22 studies were included in the final analysis. The risk of bias and methodological quality assessment revealed that out of 22 studies analyzed, five (23%) had a high risk of bias, while 13 (59%) were classified as moderate risk, and four (18%) showed low risk. This distribution highlights a predominance of moderate-risk studies in research on imaging in IBD, emphasizing the need for enhanced study designs in future investigations. Our findings revealed the varying effectiveness of imaging modalities in diagnosing complications of CD and UC. Magnetic resonance enterography (MRE) stands out as the preferred method for CD due to its high sensitivity and noninvasive nature. In contrast, colonoscopy remains the gold standard for UC, providing direct visualization of mucosal lesions. While techniques like ultrasound and capsule endoscopy offer valuable insights, they have limitations that may affect their utility in certain cases.
炎症性肠病（IBD）涵盖复杂的胃肠道疾病，主要是克罗恩病（CD）和溃疡性结肠炎（UC），需要精确的影像学检查以有效诊断和处理并发症。本系统评价旨在评估影像学检查在诊断IBD及检测相关并发症方面的当前作用。该评价遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。我们使用文本词和控制词汇，并应用布尔运算符“AND”“OR”，在PubMed、Embase和Cochrane图书馆等数据库上进行了各种组合的文献检索。检索对象为2005年至2024年发表的、涉及人类、有全文且为英文的开放获取文章。使用Cochrane偏倚风险（RoB）清单评估纳入研究的质量。我们的检索过程从Cochrane（39条）、Embase（29条）和PubMed（59条）中识别出127条记录。在去除98条不相关记录后，29条记录接受进一步筛选。其中5条因涉及不相关问题或结果而被排除，最终剩下24篇全文报告，均可供获取。经过资格评估，又有2篇报告因无法获取而被排除，最终22项研究纳入最终分析。偏倚风险和方法学质量评估显示，在分析的22项研究中，5项（23%）偏倚风险高，13项（59%）为中度风险，4项（18%）为低风险。这种分布突出了IBD影像学研究中中度风险研究占主导地位，强调未来研究需要改进研究设计。我们的研究结果揭示了影像学检查在诊断CD和UC并发症方面的不同有效性。磁共振肠造影（MRE）因其高敏感性和非侵入性，是诊断CD的首选方法。相比之下，结肠镜检查仍是UC的金标准，可直接观察黏膜病变。虽然超声和胶囊内镜等技术提供了有价值的见解，但它们存在局限性，在某些情况下可能会影响其效用。
