Crohn病における全層性炎症評価の意義—MREの立場から

Significance of Evaluating Small Intestinal Transmural Inflammation in Crohn's Disease：From the Standpoint of Magnetic Resonance Enterography

要旨●Crohn病において内視鏡的粘膜治癒の達成を目指した治療戦略は，持続的な長期臨床的寛解を実現する治療目標として重要視されてきた．しかしながらCrohn病は全層性炎症であることから，MREなどのcross sectional imagingによる全層性炎症の消失は表層性の炎症消失を意味する内視鏡的粘膜治癒よりも良好な予後と相関することが報告されている．今後MREなどによる疾患のモニタリングが確立していくことで，疾患の経過をさらに改善し不可逆的な腸の損傷を防ぐことが期待される．

　CD（Crohn's disease）is characterized by chronic transmural inflammation of the gastrointestinal tract. Therapeutic strategies targeting endoscopic mucosal healing in CD have been emphasized to achieve sustained clinical remission. However, CD causes transmural inflammation, whereas endoscopic healing only implies resolving superficial inflammation. Achieving transmural healing, as assessed by cross-sectional imaging, such as magnetic resonance enterography, has been reported to correlate better with disease-related outcomes than endoscopic mucosal healing. Therefore, monitoring the transmural disease by cross-sectional imaging should be established to further improve the disease course and prevent irreversible intestinal damage.