克罗恩病肠狭窄纤维化的影像学评估进展

Progress in Imaging Evaluation of Fibrotic Intestinal Stenosis in Crohn's Disease

  • 摘要: 肠狭窄是克罗恩病(Crohn's disease, CD)的严重并发症, 准确鉴别纤维性狭窄对临床治疗决策具有重要指导价值。由于肠狭窄常导致内窥镜通过困难, 使得病变评估和组织活检受到限制, 而横断面成像技术不仅能全面评估肠道病变, 还能显示肠外改变, 为临床决策提供了关键依据。随着成像技术的快速发展, 多种新型影像学方法为CD肠狭窄纤维化评估提供了新思路。本文通过文献回顾, 总结超声弹性成像、MRI扩散加权成像、磁化转移MRI以及成纤维细胞活化蛋白抑制剂-正电子发射断层扫描等先进影像技术的最新研究进展, 并探讨人工智能与影像组学在CD纤维化检测和分级中的应用前景与发展方向。

     

    Abstract: Intestinal stricture is a severe complication of Crohn's disease (CD), and the accurate differentiation of fibrotic strictures holds significant clinical value for guiding therapeutic decision-making. Due to the frequent difficulty in endoscopic passage caused by luminal narrowing, the assessment of lesions and tissue biopsy are often limited. In contrast, cross-sectional imaging techniques not only provide a comprehensive evaluation of intestinal lesions but also reveal extraintestinal changes, offering critical evidence for clinical decisions. With the rapid advancement of imaging technology, various novel radiological methods have emerged, providing new approaches for the assessment of intestinal fibrosis in CD strictures. Through a literature review, this article summarizes the latest research progress in advanced imaging techniques, including ultrasound elastography, magnetic resonance imaging(MRI) diffusion-weighted imaging, magnetization transfer MRI, and fibroblast activation protein inhibitor (FAPI)- positron emission computed tomography(PET). Additionally, it explores the potential applications and future directions of artificial intelligence and radiomics in the detection and grading of CD-associated fibrosis.

     

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