International expert guidance for defining and monitoring small bowel strictures in Crohn's disease on intestinal ultrasound: a consensus statement.

作者：Cathy Lu, R. Rosentreter, C. Parker, J. Rémillard, Stephanie R. Wilson, M. Baker, G. Bhatnagar, Jakob Begun, D. Bruining, Robert V Bryant, Britt Christensen, B. Feagan, J. Fletcher, I. Gordon, Gaylyn Henderson, V. Jairath, John M. Knudsen, T. Kucharzik, K. Lesack, C. Maaser, G. Maconi, K. Novak, Jordi Rimola, Stuart A. Taylor, R. Wilkens, F. Rieder · 发表于：The Lancet Gastroenterology and Hepatology · 年份：2024 · DOI：10.1016/s2468-1253(24)00265-6 · 被引用次数：32 · 研究领域：Medicine

BACKGROUND Diagnostic imaging using CT enterography, magnetic resonance enterography, and intestinal ultrasound are important tools in evaluating stricturing Crohn's disease. Definitions of strictures have been developed for CT enterography and magnetic resonance enterography. However, expert recommendations for definitions and treatment response of strictures on intestinal ultrasound are not available. The aim of this study was to standardise definitions, diagnosis, and treatment response criteria in small bowel stricturing Crohn's disease on intestinal ultrasound. METHODS Using modified RAND-University of California Los Angeles Appropriateness Method, a diverse expert panel of 13 gastroenterologists, seven radiologists, and two patient representatives was assembled. A total of 466 statements on definitions and response to therapy of stricturing Crohn's disease on intestinal ultrasound were generated from a systematic review and from expert opinion, with subsequent rating for appropriateness. Two rounds of voting with an interposed survey result discussion were performed. Statements were classified as inappropriate, uncertain, or appropriate based on the median panel rating and degree of disagreement. Appropriateness was rated using a nine-point Likert scale (1 being inappropriate, 9 being highly appropriate). FINDINGS A naive or anastomotic small bowel Crohn's disease stricture on intestinal ultrasound is defined by the combination of bowel wall thickening, luminal narr...