Crohn’s disease at radiological imaging: focus on techniques and intestinal tract

Abstract

noscopy with biopsy is considered the reference standard for achieving a definitive diagnosis, as it can access hard-to-reach areas of the small intestine and can replace surgery in treatment of strictures through balloon dilation. 7 However, the main limits include invasiveness, related risks (i.e., bowel perforation) and a partial evaluation, limited to the mucosal surface. 8 Therefore, radiological imaging is of paramount importance in the estimation of the whole intestinal involvement, not only for the initial evaluation, but also for follow-up monitoring and treatment response assessment. 9,10 Beyond the mere detection of intestinal lesions, it can provide useful data concerning characteristics of bowel wall thickening, which is helpful in distinguishing active inflammation from fibrosis, along with and valuable information on the surrounding tissues, where complications arise. 11 The constant development of novel technical tools and techniques is a benefit for improving the patient' s clinical framework. On the other hand, the different imaging modalities and the number of tools and techniques they are provided with can be confounding while establishing the prop

Endoscopic activity in inflammatory bowel disease: clinical significance and application in practice

“…It is more challenging to develop an endoscopic index for CD that can accurately assess mucosal lesions in CD because, unlike UC, CD involves multiple locations and phenotypes. 25 , 26 To date, two validated endoscopic scoring systems exist for CD. The first system is the Crohn's Disease Endoscopic Index of Severity (CDEIS), reported in 1989 by the Groupe d’Etudes Therapeutiques des affections Inflammatoires du tube Digestif 27 which was validated prospectively and reproducible with a good inter-observer agreement.…”

Comparison of an Endoscopic Scoring System and the Simplified Magnetic Resonance Index of Activity in Patients with Small Bowel Crohn’s Disease

“…The CSI was referred to as an adjunctive tool for estimating transmural healing (TH). 2,3 CD is characterized by the transmural involvement of the intestine. 4 There are arguments that TH should be con-sidered a therapeutic goal, going one step further.…”

Unique coexistence of chronic midgut malrotation, mesenteric cyst, and pancreas divisum in a Crohn's disease patient: MR-enterography assessment

“…Nevertheless, the MRE protocol, mainly based on T2-weighted sequences, allows to recognize fluid structures such as mesenteric cysts or pancreatic ducts [5 , 6] .…”