Crohn Disease Imaging (2021)-W6-CGI09-2021

Video Transcription
Video Summary
The discussion primarily focused on the identification, classification, and treatment of stricturing and penetrating Crohn's disease, emphasizing the complexities in diagnosing and managing different phenotypes through standardized imaging techniques. The importance of using established references and methodologies to identify disease characteristics accurately was stressed, citing the need for consistent observer agreement.<br /><br />The conversation highlighted the pathophysiology of stricturing Crohn's disease, noting the significant overlap of inflammation and fibrosis within intestinal strictures. It was indicated that most medical therapies aim to reduce inflammation rather than reverse fibrosis, often necessitating surgical interventions for persistent strictures.<br /><br />Penetrating disease in Crohn’s was also covered, entailing the formation of fistulae and abscesses, often traced back to strictured sections. The need for precise imaging to discern between different types of pathology, like fistulae and sinus tracts, was emphasized to aid in surgical planning and treatment evaluation.<br /><br />Multiple imaging modalities, including CT and MRI, were discussed for their roles in assessing disease activity and response to treatment. The shift towards more standardized, objective assessments and reporting practices in imaging was encouraged to improve inter-radiologist agreement and support better clinical outcomes.<br /><br />Moreover, the potential use of bowel ultrasound and MRI in pediatric and adult populations for diagnosing Crohn’s-associated perianal fistulas was mentioned, reinforcing the utility of MRI for detailed assessment and classification, particularly in complex cases.<br /><br />Treatment strategies were discussed, including drainage of abscesses and potential surgical interventions, illustrating the multidisciplinary approach required in managing Crohn’s disease complications effectively.
Keywords
Crohn's disease
stricturing
penetrating
imaging techniques
inflammation
fibrosis
fistulae
MRI
surgical interventions
treatment strategies