Open AccessCrohn's disease related strictures in cross‐sectional imaging: More than meets the eye?
Author(s) -
Sleiman Joseph,
Chirra Prathyush,
Gandhi Namita S.,
Baker Mark E.,
Lu Cathy,
Gordon Ilyssa O.,
Viswanath Satish E.,
Rieder Florian
Publication year - 2022
Publication title -
united european gastroenterology journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1002/ueg2.12326
Subject(s) - medicine , crohn's disease , modalities , disease , inflammatory bowel disease , pathology , extracellular matrix , fibrosis , treatment modality , radiology , social science , sociology , biology , microbiology and biotechnology
Abstract Strictures in Crohn's disease (CD) are a hallmark of long‐standing intestinal damage, brought about by inflammatory and non‐inflammatory pathways. Understanding the complex pathophysiology related to inflammatory infiltrates, extracellular matrix deposition, as well as muscular hyperplasia is crucial to produce high‐quality scoring indices for assessing CD strictures. In addition, cross‐sectional imaging modalities are the primary tool for diagnosis and follow‐up of strictures, especially with the initiation of anti‐fibrotic therapy clinical trials. This in turn requires such modalities to both diagnose strictures with high accuracy, as well as be able to delineate the impact of each histomorphologic component on the individual stricture. We discuss the current knowledge on cross‐sectional imaging modalities used for stricturing CD, with an emphasis on histomorphologic correlates, novel imaging parameters which may improve segregation between inflammatory, muscular, and fibrotic stricture components, as well as a future outlook on the role of artificial intelligence in this field of gastroenterology.