| [ Summary ] |
Crohn's disease (CD) is a lifelong, chronic, progressive inflammatory disease of the gastrointestinal tract. It is associated with inflammation throughout the small and large bowels that causes irreversible bowel damage, such as strictures, fistulae, and abscesses. These complications may occur even in patients who have achieved clinical remission (CR). To optimize therapy for CD, it is necessary to monitor disease activity and evaluate the effects of therapeutic interventions. Because targeting CR does not improve long-term outcomes in CD, there has been interest in identifying treatment targets that, if used, would alter the natural history of the disease early in its course. One such target that has been studied is mucosal healing (MH), or endoscopic remission. A systematic review and meta-analysis showed that achieving MH was associated with increased rates of long-term clinical remission, suggesting that MH may be a reasonable therapeutic target. Many new imaging modalities have been developed in recent years, including video capsule endoscopy (VCE), balloon-assisted enteroscopy (BAE), ultrasonography (US), computed tomography enterography (CTE), and magnetic resonance enterography/enterocolonography (MRE/MREC). CTE and MRE/MREC are cross-sectional imaging techniques used to investigate not only extraluminal abnormalities, but also intraluminal changes. A suitable imaging modality should be reproducible, welltolerated, and safe : It must be free of ionizing radiation, which is associated with a cumulative risk, because CD is a lifelong disease. |