MRI在克罗恩病肛瘘活动性评价与随诊中的研究进展

Research progress of MRI in activity evaluation and follow-up of perianal fistulizing Crohn's disease

克罗恩病(Crohn’s disease, CD)是一种病因不明的慢性非特异性炎症性肠病。CD肛瘘(perianal fistulizing CD,pfCD)作为CD最常见的并发症,常发生在成人和儿童CD中。随着医学技术的不断发展,多种辅助检查方法应运而生,如内镜、瘘管造影、麻醉下探查、腔内超声、MRI等皆可辅助诊断。其中MRI具有无创、快速、准确等特点,已经成为pfCD影像学诊断的金标准。本文就盆腔MRI在pfCD的诊断价值、鉴别诊断与疗效评估进行综述。同时考虑到pfCD的复杂性,本文还探讨了CD的MRI炎症活动评分、影像学指标和基于MRI的新技术,以期为pfCD患者诊治策略的进一步优化提供理论依据。

Crohn's disease(CD)is a chronic nonspecific inflammatory bowel disease of unknown etiology.Perianal fistulizing Crohn's disease(pfCD)is the most common complication of CD and frequently occurs in both adults and children.With the continuous development of medical technology,a variety of imaging-assisted examination techniques came into being,such as endoscopy,fistula angiography,examination under anesthesia,endoscopic ultrasonography,MRI etc.,can assist in diagnosis.MRI has become the gold standard for the imaging diagnosis of pfCD due to its non-invasive,rapid and accurate characteristics.This paper reviews the diagnostic value,differential diagnosis and efficacy evaluation of pelvic MRI in pfCD.Considering the complexity of pfCD,this paper also discussed the MRI inflammatory activity score,imaging indicators and new MRI based technology of CD,in order to provide theoretical basis for further optimization of diagnosis and treatment strategies for patients with pfCD.