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Der Radiologe

, Volume 58, Issue 4, pp 344–354 | Cite as

Perianale entzündliche Erkrankungen

Klassifikation und Bildgebung
  • A.-O. Schäfer
Leitthema
  • 354 Downloads

Zusammenfassung

In den vergangenen 30 Jahren wurden Klassifikationen und Scoring-Systeme entwickelt, um den Ausprägungsgrad und die Entzündungsaktivität von Patienten mit anorektalen Fisteln und Abszessen zu objektivieren und zu messen. Wenige dieser Instrumente haben bislang Einzug in die breite klinische Routine gefunden, u. a. da Aktivitätsindizes häufig komplex aufgebaut sind und ihre Bearbeitung Zeit beansprucht. Die Analyse der Erkrankungsaktivität von Crohn-Patienten ist aber integraler Bestandteil klinischer Studien und besitzt einen hohen Stellenwert für die Responsebeurteilung invasiver und nichtinvasiver Therapieformen. Die Jahre 1976 und 1995 können als Meilensteine für die Einteilung der Erkrankungsschwere von Patienten mit kryptoglandulären Fisteln und perianalen Crohn-Manifestationen bezeichnet werden. Zu diesen Zeitpunkten entstanden die Parks-Klassifikation und der Perianale Erkrankungsaktivitäts-Index (PDAI). Sie gelten bis heute als Goldstandard in der Klassifikation anorektaler Fistelerkrankungen.

Schlüsselwörter

Analfistel Entzündung Morbus Crohn Acne inversa Magnetresonanztomographie 

Perianal inflammatory diseases

Classification and imaging

Abstract

During the past 30 years, classifications and scoring systems have been developed in order to evaluate and objectify the degree and activity of anorectal fistulas. Only a few of these disease-specific instruments have been adopted into daily clinical routine. Generally, clinicians tend to use global medical judgement rather than numeric activity indices, which often seem complex and time consuming. Activity scores in Crohn disease, however, appeared to be very useful in clinical trials regarding evaluation of therapy response. Thus, activity indices must be simple and reproducible. The years 1976 and 1995, in which the Parks Classification and Perianal Disease Activity Index (PDAI) were established, can be considered milestone years for classifying patients with anorectal fistulizing disease. These instruments should be recognized at present as the gold standard for evaluating the complexity as well as the severity of anorectal fistulas and perianal Crohn disease.

Keywords

Anal fistula Inflammation Crohn disease Acne inversa Magnetic resonance imaging 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

A.-O. Schäfer gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für RadiologieStädtisches Klinikum St. Georg LeipzigLeipzigDeutschland

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