Clinical Gastroenterology and Hepatology最新文献

英文中文

The EXTENT Study: Results From an International Expert Delphi Consensus to Define Ultrasonographic Parameters for Measuring Bowel Damage in Crohn's Disease. EXTENT研究：来自国际专家德尔菲共识的结果，以确定克罗恩病中测量肠损伤的超声参数。

IF 12 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-04-01 Epub Date: 2025-07-28 DOI: 10.1016/j.cgh.2025.07.024

Carolina Palmela, Joana Torres, Catarina Frias-Gomes, Mariangela Allocca, Anthony Buisson, Jean-Frederic Colombel, Kerri Novak, Jordi Rimola, Ahmad Albshesh, Cristiana Bonifacio, Noa Krugliak Cleveland, Floris De Voogd, Michael Dolinger, Federica Furfaro, Aranzazu Jauregui-Amezaga, Tarkan Karakan, Amelia Kellar, Dominik Kralj, Cathy Lu, Maarten Pruijt, Florian Rieder, Gorm Roager Madsen, Kayal Vizhi Nagarajan, Shintaro Sagami, Martina Scharitzer, Jaap Stoker, Stuart A Taylor, Hauke Christian Tews, Ragna Vanslembrouck, Rose Vaughan, Rune Wilkens, Christian Maaser, Bram Verstockt

Background & aims: A primary aim in managing Crohn's disease (CD) is preventing bowel damage. The Lémann index (LI) quantifies structural bowel damage using magnetic resonance enterography (MRE) or computed tomography enterography (CTE) and, for colonic CD, colonoscopy. Intestinal ultrasonography (IUS) provides a noninvasive imaging alternative, although its role in LI assessment remains unexplored. This study aimed to establish a consensus on parameters and acquisition protocol for scoring small bowel and colonic damage using IUS in evaluating the LI.

Methods: Thirty international experts in IUS and/or MRE participated in a 3-round Delphi process. Participants provided feedback and rated statements on IUS parameters and acquisition protocol in 2 online rounds. During the final in-person round, unresolved items were discussed and voted upon. Statements with at least 80% agreement were accepted.

Results: Twenty-two statements reached a consensus: 10 defined IUS parameters for stricturing and penetrating lesions for scoring LI-IUS, and 12 addressed optimal IUS cineloop acquisition for centralized review. No consensus on IUS equivalents for grade 1 stricturing lesions in the small bowel and colon was reached.

Conclusions: Ultrasonographic equivalents for assessing small bowel and colonic damage in CD were derived to align with the validated LI criteria for MRE and colonoscopy. These statements mark the first phase of the EXTENT project, supporting the potential use of IUS in clinical practice and disease modification trials as an alternative tool for bowel damage assessment. The lack of consensus on grade 1 stricturing lesions suggests further exploration of IUS parameters is required.

背景与目的：治疗克罗恩病（CD）的主要目的是预防肠道损伤。l曼指数（LI）通过磁共振肠造影（MRE）或计算机断层肠造影（CTE）和结肠镜检查（结肠CD）来量化肠道结构性损伤。肠道超声检查（IUS）提供了一种非侵入性的替代成像方法，尽管其在LI评估中的作用尚未探索。本研究旨在建立使用IUS评估小肠和结肠损伤的参数和获取方案的共识。方法：30名国际IUS和/或MRE专家参加了三轮德尔菲过程。参与者对IUS参数和采集方案进行了两轮在线反馈和评价。在最后一轮面对面的讨论中，未解决的问题进行了讨论和投票。至少有80%同意的陈述被接受。结果：22项声明达成共识：10项定义了狭窄性和穿透性病变的IUS参数，用于LI-IUS评分，12项针对集中评价的最佳IUS循环获取。对于小肠和结肠1级狭窄病变的等效IUS，尚未达成共识。结论：用于评估CD小肠和结肠损伤的超声等效物与MRE和结肠镜检查的有效LI标准一致。这些声明标志着EXTENT项目的第一阶段，支持IUS在临床实践和疾病修饰试验中作为肠损伤评估的替代工具的潜在应用。对1级狭窄病变缺乏共识表明需要进一步探索IUS参数。

{"title":"The EXTENT Study: Results From an International Expert Delphi Consensus to Define Ultrasonographic Parameters for Measuring Bowel Damage in Crohn's Disease.","authors":"Carolina Palmela, Joana Torres, Catarina Frias-Gomes, Mariangela Allocca, Anthony Buisson, Jean-Frederic Colombel, Kerri Novak, Jordi Rimola, Ahmad Albshesh, Cristiana Bonifacio, Noa Krugliak Cleveland, Floris De Voogd, Michael Dolinger, Federica Furfaro, Aranzazu Jauregui-Amezaga, Tarkan Karakan, Amelia Kellar, Dominik Kralj, Cathy Lu, Maarten Pruijt, Florian Rieder, Gorm Roager Madsen, Kayal Vizhi Nagarajan, Shintaro Sagami, Martina Scharitzer, Jaap Stoker, Stuart A Taylor, Hauke Christian Tews, Ragna Vanslembrouck, Rose Vaughan, Rune Wilkens, Christian Maaser, Bram Verstockt","doi":"10.1016/j.cgh.2025.07.024","DOIUrl":"10.1016/j.cgh.2025.07.024","url":null,"abstract":"Background & aims: A primary aim in managing Crohn's disease (CD) is preventing bowel damage. The Lémann index (LI) quantifies structural bowel damage using magnetic resonance enterography (MRE) or computed tomography enterography (CTE) and, for colonic CD, colonoscopy. Intestinal ultrasonography (IUS) provides a noninvasive imaging alternative, although its role in LI assessment remains unexplored. This study aimed to establish a consensus on parameters and acquisition protocol for scoring small bowel and colonic damage using IUS in evaluating the LI.Methods: Thirty international experts in IUS and/or MRE participated in a 3-round Delphi process. Participants provided feedback and rated statements on IUS parameters and acquisition protocol in 2 online rounds. During the final in-person round, unresolved items were discussed and voted upon. Statements with at least 80% agreement were accepted.Results: Twenty-two statements reached a consensus: 10 defined IUS parameters for stricturing and penetrating lesions for scoring LI-IUS, and 12 addressed optimal IUS cineloop acquisition for centralized review. No consensus on IUS equivalents for grade 1 stricturing lesions in the small bowel and colon was reached.Conclusions: Ultrasonographic equivalents for assessing small bowel and colonic damage in CD were derived to align with the validated LI criteria for MRE and colonoscopy. These statements mark the first phase of the EXTENT project, supporting the potential use of IUS in clinical practice and disease modification trials as an alternative tool for bowel damage assessment. The lack of consensus on grade 1 stricturing lesions suggests further exploration of IUS parameters is required.","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":"1102-1110"},"PeriodicalIF":12.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Urine Proteomics in Cirrhosis and Acute Kidney Injury: Insights Into the Pathogenesis of Hepatorenal Syndrome. 肝硬化和急性肾损伤的尿蛋白质组学：对肝肾综合征发病机制的见解。

IF 12 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-04-01 Epub Date: 2025-08-13 DOI: 10.1016/j.cgh.2025.08.003

Laura Napoleone, Mikel Azkargorta, Julia Sidorova, Adrià Juanola, Elisa Pose, Pere Ginès

引用次数: 0

Marked Improvement in Food Impaction Biopsy Rate (FIBR) After Implementation of a Multicenter Behavioral Intervention. 实施多中心行为干预后，食物嵌塞活检率（FIBR）显著改善。

IF 12 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology

Pub Date : 2026-04-01 Epub Date: 2025-05-06 DOI: 10.1016/j.cgh.2025.01.027

Walker D Redd, Courtney M Richman, Trevor S Barlowe, Sabrina J Layne, Ángel A Miró-González, David A Leiman