Prognostic role of intestinal ultrasound in Crohn's disease

被引:5
作者
Manzotti, Cristina [1 ]
Colombo, Francesco [2 ,3 ]
Zurleni, Tommaso [2 ]
Danelli, Piergiorgio [2 ]
Maconi, Giovanni [1 ]
机构
[1] Univ Milan, L Sacco Univ Hosp, Dept Biomed & Clin Sci, Gastroenterol Unit, I-20157 Milan, Italy
[2] Univ Milan, L Sacco Univ Hosp, Dept Biomed & Clin Sci, Div Gen Surg, I-20157 Milan, Italy
[3] Univ Milan, L Sacco Univ Hosp, Dept Biomed & Clin Sci, Div Gen Surg, Via Giovanni Battista Grassi 74, I-20157 Milan, Italy
关键词
Intestinal ultrasound; Crohn's disease; Postoperative recurrence; Bowel wall thickness; Remission; Intestinal surgery; BOWEL ULTRASOUND; MAINTENANCE TREATMENT; SONOGRAPHIC RESPONSE; FOLLOW-UP; THERAPY; SURGERY; RECURRENCE; PREDICT; ULTRASONOGRAPHY; INFLIXIMAB;
D O I
10.3748/wjg.v29.i23.3595
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The majority of patients affected by Crohn's disease (CD) develop a chronic condition with persistent inflammation and relapses that may cause progressive and irreversible damage to the bowel, resulting in stricturing or penetrating complications in around 50% of patients during the natural history of the disease. Surgery is frequently needed to treat complicated disease when pharmacological therapy failes, with a high risk of repeated operations in time. Intestinal ultrasound (IUS), a non-invasive, cost-effective, radiation free and reproducible method for the diagnosis and follow-up of CD, in expert hands, allow a precise assessment of all the disease manifestations: Bowel characteristics, retrodilation, wrapping fat, fistulas and abscesses. Moreover, IUS is able to assess bowel wall thickness, bowel wall stratification (echo-pattern), vascularization and elasticity, as well as mesenteric hypertrophy, lymph-nodes and mesenteric blood flow. Its role in the disease evaluation and behaviour description is well assessed in literature, but less is known about the potential space of IUS as predictor of prognostic factors suggesting response to a medical treatment or postoperative recurrence. The availability of a low cost exam as IUS, able to recognize which patients are more likely to respond to a specific therapy and which patients are at high risk of surgery or complications, could be a very useful instrument in the hands of IBD physician. The aim of this review is to present current evidence about the prognostic role that IUS can show in predicting response to treatment, disease progression, risk of surgery and risk of post-surgical recurrence in CD.
引用
收藏
页码:3595 / 3605
页数:11
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