title: Assessment of stricturing Crohn's disease: Current clinical practice and future avenues.
abstract: 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 (18)F-FDG PET/CT, molecular imaging approaches and biomarkers, are critically reviewed with regard to their potential role in assessing stricturing CD.
authors.affiliation: Dominik Bettenworth, Tobias M Nowacki, Friederike Cordes, Frank Lenze, Department of Medicine B, University Hospital of Muenster, 48149 Muenster, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Bettenworth
authors.affiliation: Dominik Bettenworth, Tobias M Nowacki, Friederike Cordes, Frank Lenze, Department of Medicine B, University Hospital of Muenster, 48149 Muenster, Germany.
authors.forename: Tobias M
authors.initials: TM
authors.lastname: Nowacki
authors.affiliation: Dominik Bettenworth, Tobias M Nowacki, Friederike Cordes, Frank Lenze, Department of Medicine B, University Hospital of Muenster, 48149 Muenster, Germany.
authors.forename: Friederike
authors.initials: F
authors.lastname: Cordes
authors.affiliation: Dominik Bettenworth, Tobias M Nowacki, Friederike Cordes, Frank Lenze, Department of Medicine B, University Hospital of Muenster, 48149 Muenster, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Buerke
authors.affiliation: Dominik Bettenworth, Tobias M Nowacki, Friederike Cordes, Frank Lenze, Department of Medicine B, University Hospital of Muenster, 48149 Muenster, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Lenze
mesh_terms: D003251:Constriction, Pathologic; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis; D003952:Diagnostic Imaging / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology; D007422:Intestines / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011379:Prognosis
keywords: 18F-FDG PET/CT CEUS; Computed tomography; Crohn’s disease; Elastography; Endoscopy; Inflammatory bowel disease; Intestinal stricture; Magnetic resonance imaging; Ultrasound
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