Assessment of stricturing Crohn's disease: Current clinical practice and future avenues

被引:38
作者
Bettenworth, Dominik [1 ]
Nowacki, Tobias M. [1 ]
Cordes, Friederike [1 ]
Buerke, Boris [2 ]
Lenze, Frank [1 ]
机构
[1] Univ Hosp Muenster, Dept Med B, Albert Schweitzer Campus 1,Bldg A1, D-48149 Munster, Germany
[2] Univ Hosp Muenster, Dept Clin Radiol, D-48149 Munster, Germany
关键词
Crohn's disease; Inflammatory bowel disease; Intestinal stricture; Endoscopy; Magnetic resonance imaging; Ultrasound; Computed tomography; F-18-FDG PET/CT CEUS; Elastography; INFLAMMATORY-BOWEL-DISEASE; MAGNETIC-RESONANCE ENTEROGRAPHY; CONTRAST-ENHANCED ULTRASOUND; DOUBLE-BALLOON ENDOSCOPY; EVIDENCE-BASED CONSENSUS; INTESTINAL INFLAMMATION; NONINVASIVE DIAGNOSIS; COMPUTED-TOMOGRAPHY; F-18-FDG PET/CT; NATURAL-HISTORY;
D O I
10.3748/wjg.v22.i3.1008
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Crohn's disease (CD) is a chronic remittent idiopathic disease. Although the early phase of the disease is commonly characterized by inflammation-driven symptoms, such as diarrhea, the frequency of fibrostenotic complications in patients with CD increases over the long-term course of the disease. This review presents the current diagnostic options for assessing CD-associated strictures. In addition to the endoscopic evaluation of CD strictures, this review summarizes the currently available imaging modalities, including ultrasound and cross-sectional imaging techniques. In addition to stricture detection, differentiating between the primarily inflammatory strictures and the predominantly fibrotic ones is essential for selecting the appropriate treatment strategy (anti-inflammatory medical treatment vs endoscopical or surgical approaches). Therefore, recent imaging advances, such as contrast-enhanced ultrasound and ultrasound elastography, contribute to the development of non-invasive non-radiating imaging of CD-associated strictures. Finally, novel magnetic resonance imaging techniques, such as diffusion-weighted, motility and magnetization transfer imaging, as well as F-18-FDG PET/CT, molecular imaging approaches and biomarkers, are critically reviewed with regard to their potential role in assessing stricturing CD.
引用
收藏
页码:1008 / 1016
页数:9
相关论文
共 91 条
[21]   Ultrasound Shear Wave Elastography Helps Discriminate Low-grade From High-grade Bowel Wall Fibrosis in Ex Vivo Human Intestinal Specimens [J].
Dillman, Jonathan R. ;
Stidham, Ryan W. ;
Higgins, Peter D. R. ;
Moons, David S. ;
Johnson, Laura A. ;
Keshavarzi, Nahid R. ;
Rubin, Jonathan M. .
JOURNAL OF ULTRASOUND IN MEDICINE, 2014, 33 (12) :2115-2123
[22]   US Elastography-derived Shear Wave Velocity Helps Distinguish Acutely Inflamed from Fibrotic Bowel in a Crohn Disease Animal Model [J].
Dillman, Jonathan R. ;
Stidham, Ryan W. ;
Higgins, Peter D. R. ;
Moons, David S. ;
Johnson, Laura A. ;
Rubin, Jonathan M. .
RADIOLOGY, 2013, 267 (03) :757-766
[23]   Disease Behavior in Adult Patients: Are There Predictors for Stricture or Fistula Formation? [J].
Dotan, Iris .
DIGESTIVE DISEASES, 2009, 27 (03) :206-211
[24]   Ionizing radiation exposure in patients with inflammatory bowel disease: Are we overexposing our patients? [J].
Estay, Camila ;
Simian, Daniela ;
Lubascher, Jaime ;
Figueroa, Carolina ;
O'Brien, Andres ;
Quera, Rodrigo .
JOURNAL OF DIGESTIVE DISEASES, 2015, 16 (02) :83-89
[25]   Small bowel adenocarcinoma in Crohn's disease [J].
Feldstein, Richard C. ;
Sood, Shivani ;
Katz, Seymour .
INFLAMMATORY BOWEL DISEASES, 2008, 14 (08) :1154-1157
[26]   Validation of Endoscopic Activity Scores in Patients With Crohn's Disease Based on a Post Hoc Analysis of Data From SONIC [J].
Ferrante, Marc ;
Colombel, Jean-Frederic ;
Sandborn, William J. ;
Reinisch, Walter ;
Mantzaris, Gerassimos J. ;
Kornbluth, Asher ;
Rachmilewitz, Daniel ;
Lichtiger, Simon ;
D'Haens, Geert R. ;
Van Der Woude, Christien J. ;
Danese, Silvio ;
Diamond, Robert H. ;
Oortwijn, Alessandra Faria ;
Tang, Kezhen L. ;
Miller, Michael ;
Cornillie, Freddy ;
Rutgeerts, Paul J. .
GASTROENTEROLOGY, 2013, 145 (05) :978-+
[27]   Prospective Comparison of Computed Tomography Enterography and Magnetic Resonance Enterography for Assessment of Disease Activity and Complications in Ileocolonic Crohn's Disease [J].
Fiorino, G. ;
Bonifacio, C. ;
Peyrin-Biroulet, L. ;
Minuti, F. ;
Repici, A. ;
Spinelli, A. ;
Fries, W. ;
Balzarini, L. ;
Montorsi, M. ;
Malesci, A. ;
Danese, S. .
INFLAMMATORY BOWEL DISEASES, 2011, 17 (05) :1073-1080
[28]   Therapy for Fibrotic Diseases: Nearing the Starting Line [J].
Friedman, Scott L. ;
Sheppard, Dean ;
Duffield, Jeremy S. ;
Violette, Shelia .
SCIENCE TRANSLATIONAL MEDICINE, 2013, 5 (167)
[29]   Diagnosis and treatment of small-bowel stricture by double balloon endoscopy [J].
Fukumoto, Akira ;
Tanaka, Shinji ;
Yamamoto, Hironori ;
Yao, Tsuneyoshi ;
Matsui, Toshiyuki ;
Iida, Mitsuo ;
Goto, Hidemi ;
Sakamoto, Choitsu ;
Chiba, Tsutomu ;
Sugano, Kentaro .
GASTROINTESTINAL ENDOSCOPY, 2007, 66 (03) :S108-S112
[30]   Transabdominal bowel sonography for the detection of intestinal complications in Crohn's disease [J].
Gasche, C ;
Moser, G ;
Turetschek, K ;
Schober, E ;
Moeschl, P ;
Oberhuber, G .
GUT, 1999, 44 (01) :112-117