• Angiogenesis
• Broad-spectrum
• Endostar
• Endostatin

• Humans
• Endostatins/therapeutic use
• Endostatins/metabolism
• Endostatins/adverse effects
• Neoplasms/drug therapy
• Neoplasms/pathology
• Neoplasms/blood supply
• Neoplasms/metabolism
• Animals
• Angiogenesis Inhibitors/therapeutic use
• Angiogenesis Inhibitors/adverse effects
• Neovascularization, Pathologic/drug therapy
• Signal Transduction/drug effects

• Colonoscopy
• Crohn’s disease
• Endoscopy
• Imaging modalities
• Inflammatory bowel disease
• Therapeutic interventions
• Ulcerative colitis

• Humans
• Colonoscopy/methods
• Inflammatory Bowel Diseases/therapy
• Inflammatory Bowel Diseases/diagnosis
• Inflammatory Bowel Diseases/diagnostic imaging
• Endoscopic Mucosal Resection/methods

• artificial intelligence
• chromoendoscopy
• confocal laser endomicroscopy
• endocytoscopy
• precision medicine

• Humans
• Artificial Intelligence
• Inflammatory Bowel Diseases/diagnosis
• Endoscopy, Gastrointestinal/methods
• Endoscopy/methods
• Endoscopic Mucosal Resection
• Inflammation

• artificial intelligence
• chromoendoscopy
• confocal laser endomicroscopy
• dysplasia
• endocytoscopy
• inflammation
• molecular endoscopy

• Humans
• Colitis, Ulcerative/diagnosis
• Colonoscopy/methods
• Severity of Illness Index
• Inflammation/pathology
• Inflammatory Bowel Diseases/pathology
• Intestinal Mucosa/diagnostic imaging
• Intestinal Mucosa/pathology

• cancer
• fibrosis
• gastrointestinal tract
• imaging
• inflammation

• Humans
• Inflammation/diagnostic imaging
• Tomography, X-Ray Computed
• Magnetic Resonance Imaging/methods
• Gastrointestinal Diseases/diagnostic imaging
• Endoscopy, Gastrointestinal/methods
• Neoplasms
• Fibrosis

• R01 CA205941 NCI NIH HHS
• F31CA261044, R01CA205941, R01CA212350 NCI NIH HHS

• Blue laser imaging (BLI)
• Electronic chromoendoscopy
• I-SCAN
• Linked colour imaging (LCI)
• flexible spectral imaging color enhancement (FICE)
• narrow-band imaging (NBI)

• Crohn's disease
• functional healing
• inflammation
• molecular imaging
• mucosal healing
• ulcerative colitis

• Colitis, Ulcerative/diagnostic imaging
• Endoscopy
• Humans
• Inflammatory Bowel Diseases/diagnostic imaging
• Mucous Membrane
• Severity of Illness Index

• artificial intelligence
• capsule enteroscopy
• confocal laser endomicroscopy
• dye-chromoendoscopy
• endocytoscopy
• inflammatory bowel diseases
• molecular imaging
• virtual chromoendoscopy

• Artificial intelligence
• chromoendoscopy
• confocal laser endomicroscopy
• endocytoscopy
• endoscopy
• inflammatory bowel disease
• molecular imaging
• optical coherence tomography
• raman spectroscopy
• surveillance

Minimally invasive diagnostic imaging techniques to detect intestinal inflammation in dogs are lacking. Contrast‐enhanced ultrasound (CEUS) and endoscopic narrow band imaging‐like endoscopy (Storz Professional Image Enhancement System [SPIES]) might allow quantification of intestinal mucosal perfusion and microvessel density in chronic inflammatory enteropathy (CIE) of dogs.

Markers of mucosal perfusion as determined by CEUS and SPIES endoscopy are potentially useful diagnostic markers to help characterize CIE and correlate with histological inflammation type and severity.

Thirty client‐owned dogs diagnosed with CIE at a referral hospital were prospectively enrolled.

Data from CEUS, SPIES, and white light (WL) endoscopy were correlated with World Small Animal Veterinary Association (WSAVA) endoscopy and histology scores and vessel density as determined by immunohistochemistry for von Willebrand factor (vWF). Automated linear modeling was used to determine predictors of endoscopic and histologic severity.

Duodenal histology correlated with SPIES data (area percentage value, rho = 0.424, P = .04). White light endoscopy parameters correlated with SPIES parameters in the duodenum. Colonic histology correlated positively with CEUS, whereas colonic CEUS parameters correlated inversely with vWF expression. Several duodenal parameters combined predicted duodenal histology scores to a level of 73.4%. For the colon, 2 parameters contributed more than others to 73.1%.

Minimally invasive CEUS and SPIES appear feasible to assess intestinal perfusion in CIE. Use of SPIES endoscopy may be promising for assessing small intestinal inflammation, whereas CEUS could be used to assess colonic perfusion and inflammation. Both techniques need to be investigated further for their clinical utility.

• immunohistochemistry
• inflammatory bowel disease
• perfusion
• ultrasound
• vessels
• von Willebrand factor

• inflammation
• intravital microscopy
• microcirculation

• Crohn’s disease
• angiogenesis
• angiopoietin
• thalidomide

• Crohn’s disease
• Ulcerative colitis
• advanced endoscopic techniques
• electronic virtual chromoendoscopy
• histological healing
• mucosal healing

Microcirculatory disturbance is an important factor in the pathogenesis of Inflammatory Bowel Disease (IBD) but there have been few studies in this field. Confocal Laser Endomicroscopy (CLE) has been used over the last 10 years and has made it possible to explore the changes in microcirculation of the colonic mucosa.

We retrospectively selected patients who underwent probe-based Confocal Laser Endomicroscopy (pCLE) between 2014 and 2016. There were 7 patients with ulcerative colitis (UC) in clinical remission and 7 healthy subjects included in this study; all the UC patients’ medical data were reviewed. For each patient, three segments of the colon were examined using pCLE including the ascending, transverse/descending and sigmoid colon. In each segment, the representative pCLE images of the three sites were selected for analysis. Four indicators, including Mean Vessel Diameter (MVD), Diameter Standard Deviation (DSD), Functional Capillary Density-long (FCDL) and Functional Capillary Density-area (FCDA), were measured with a specially designed detection software algorithm. The four indicators were compared between UC patients and healthy subjects. According to the different blood flow patterns, three types of distribution were established: the Around (A), Cobweb (C) and Deficiency (D) type. The relationships between the recurrence and blood flow patterns of UC patients were analyzed.

MVD, DSD, FCDL and FCDA were 10.62 ± 0.56 μm, 2.23 ± 0.26, 0.030 ± 0.019 μm and 0.289 ± 0.030 for the healthy subjects and 11.06 ± 1.10 μm, 2.68 ± 0.29, 0.026 ± 0.005 μm and 0.272 ± 0.034 for the UC patients, respectively. Compared with healthy subjects, DSD was significantly increased and FCDA was significantly decreased (P < 0.01 for both). There was no difference in MVD and FCDL between UC patients and healthy subjects. The type A and type C blood flows were observed in healthy subjects (66.67 and 33.33%, respectively) while type C appears more in UC patients (71.3%) and type D blood flow could only be found in UC patients (14.29%) P < 0.01. UC patients who showed Type D blood flow had a shorter recurrence interval.

Some local mucosal capillary density in UC patients was decreased, particularly in the inflammation-affected segment. The three mucosal blood flow patterns can be used as an indicator of mucosal healing.

• Confocal laser Endomicroscopy
• Inflammatory bowel disease
• Microcirculation
• Ulcerative colitis

Ulcerative colitis has hypercoagulable state and high risk of thrombosis; so mucosal disturbance of microcirculation may be mediate and amplify the inflammation of ulcerative colitis. A 56-year-old female patient was admitted in hospital for discontinuously mucous bloody stool for more than 1 year. Ulcerative colitis was determined after colonoscopy and pathologic examination. Mesalazine was effective during the year, but her symptoms recurred three times due to her bad compliance. One month before admission, the patient had severe recurrence after mesalazine withdrawal. At this time, the result of quantitative fluorescence PCR of colonic histic CMV-DNA was 1.6 × 10⁴ copies/mL positive, CMV colitis was accompanied. After 4 weeks of ganciclovir and 6 weeks of mesalazine usage and nutrition support, the symptoms of diarrhea and abdominal cramp did not improve; stool frequency was more than twenty times a day. Probe-based confocal laser endomicroscopy revealed local microcirculation disturbance. Papaverine 90-mg slow drip for at least 10 h a day was added. The symptoms dramatically disappeared after 3 days of papaverine treatment. The patient had yellow mushy stool 2–3 times a day. Pathological findings showed diffuse submucosal hemorrhage and transparent thrombosis in capillaries. Treatment of microcirculatory disturbance in severe UC is a promising adjuvant therapy. Confocal laser endomicroscopy may be an effective method for microcirculation judgment.

• Confocal laser endomicroscopy
• Microcirculatory disturbance
• Papaverine
• Ulcerative colitis

• Histological healing
• Inflammatory bowel disease
• Mucosal healing
• Target to treat approach

• Crohn disease
• complications
• contrast-enhanced ultrasound
• inflammation
• stricture
• ultrasound

• Contrast Media
• Crohn Disease/diagnostic imaging
• Crohn Disease/pathology
• Elasticity Imaging Techniques
• Humans
• Image Enhancement/methods
• Intestines/diagnostic imaging
• Intestines/pathology
• Ultrasonography/methods

Endoscopy remains the most important diagnostic and monitoring modality in the management of inflammatory bowel disease. Advances in imaging have progressively added new tools into the armamentarium of endoscopists with the goal of more accurate, sensitive, and accessible visual diagnoses for the benefit of patients with gastrointestinal diseases. Here, we review the relevant literature regarding commonly used endoscopic techniques (dye-based and digital chromoendoscopy, high-definition endoscopy, capsule endoscopy, and endosonography), as well as advanced and experimental technologies (full-spectrum endoscopy, endocytoscopy, autofluorescence, laser endoscopy, and endomicroscopy, including molecular imaging), applicable to inflammatory bowel diseases and emerging for implementation into everyday practice. Additionally, we discuss future directions and techniques as candidates for a superior inflammation imaging in the diagnosis and prediction of therapeutic response.

• Angiogenesis
• Cancer
• Gastritis
• IBD
• Microbiota
• Ulcer

Contrast-enhanced ultrasonography (CEUS) with microbubbles as a contrast agent allows the visualization and quantification of tissue perfusion. The assessment of canine intestinal perfusion by quantitative CEUS may provide valuable information for diagnosing and monitoring chronic intestinal disorders. This study aimed to assess the repeatability (intraday variability) and reproducibility (interday variability) of quantitative duodenal CEUS in healthy dogs. Six healthy beagles underwent CEUS three times within one day (4-hr intervals) and on two different days (1-week interval). All dogs were sedated with a combination of butorphanol (0.2 mg/kg) and midazolam (0.1 mg/kg) prior to CEUS. The contrast agent (Sonazoid^®) was administered using the intravenous bolus method (0.01 ml/kg) for imaging of the duodenum. Time-intensity curves (TIC) were created by drawing multiple regions of interest (ROIs) in the duodenal mucosa, and perfusion parameters, including the time-to-peak (TTP), peak intensity (PI), area under the curve (AUC), and wash-in and wash-out rates (WiR and WoR, respectively), were generated. Intraday and interday coefficients of variation (CVs) for TTP, PI, AUC, WiR and WoR were <25% (range, 2.27–23.41%), which indicated that CEUS was feasible for assessing duodenal perfusion in healthy sedated dogs. A further study of CEUS in dogs with chronic intestinal disorders is necessary to evaluate its clinical applicability.

• canine
• duodenum
• quantitative CEUS
• repeatability

• Crohn Disease/physiopathology
• Humans
• Intra-Abdominal Fat/physiopathology
• Lymphatic System/physiopathology
• Mesentery/blood supply
• Mesentery/innervation

• Angiogenesis
• Crohn’s disease
• Pediatric
• VEGF-A

• Advanced endoscopic imaging
• Chromoendoscopy
• Colitis associated cancer
• Confocal laser endomicroscopy
• Crohn’s disease
• Endocytoscopy
• Molecular imaging
• Mucosal healing
• Ulcerative colitis

• Chromogenic Compounds
• Colitis, Ulcerative/diagnostic imaging
• Colitis, Ulcerative/pathology
• Crohn Disease/diagnostic imaging
• Crohn Disease/pathology
• Endoscopy, Gastrointestinal/methods
• Humans
• Intestines/diagnostic imaging
• Intestines/pathology
• Microscopy, Confocal
• Molecular Imaging/methods
• Predictive Value of Tests
• Prognosis

Angiogenesis is an important component of pathogenesis of inflammatory bowel disease (IBD). Chronic inflammation and angiogenesis are two closely related processes. Chronic intestinal inflammation is dependent on angiogenesis and this angiogenesis is modulated by immune system in IBD. Angiogenesis is a very complex process which includes multiple cell types, growth factors, cytokines, adhesion molecules, and signal transduction. Lymphangiogenesis is a new research area in the pathogenesis of IBD. While angiogenesis supports inflammation via leukocyte migration, carrying oxygen and nutrients, on the other hand, it has a major role in wound healing. Angiogenic molecules look like perfect targets for the treatment of IBD, but they have risk for serious side effects because of their nature.

• Capsule Endoscopy
• Endoscopy, Gastrointestinal/methods
• Humans
• Inflammatory Bowel Diseases/drug therapy
• Inflammatory Bowel Diseases/pathology
• Intestinal Mucosa/pathology
• Magnetic Resonance Imaging
• Severity of Illness Index
• Wound Healing

• T32 DK007202 NIDDK NIH HHS
• 5T32DK007202-39 NIDDK NIH HHS

• Chromoendoscopy;
• Confocal laser endomicroscopy
• Crohn's disease
• Device-assisted enteroscopy
• Inflammatory Bowel Disease
• Small-bowel capsule endoscopy

• Adult
• Colitis, Ulcerative/complications
• Colitis, Ulcerative/pathology
• Colonoscopy
• Coloring Agents
• Crohn Disease/complications
• Crohn Disease/pathology
• Endoscopy
• Female
• Follow-Up Studies
• Humans
• Inflammation/diagnosis
• Inflammation/etiology
• Male
• Prognosis
• Prospective Studies
• Risk Factors
• Severity of Illness Index

The ileocecal area includes the ileocecal valve, terminal ileum, cecum, appendix, and top ascending colon. Since this area may be affected by pathologic conditions that are either common throughout the gastrointestinal system or exclusive to this area, a great variety of intestinal diseases may arise in this region, making the diagnosis of ileocecal lesions difficult. In clinic, the diagnosis of ileocecal lesions depends on the combination of disease history, clinical features, imaging and endoscopic findings. The development of advanced imaging and endoscopy technology has greatly increased the detection rate of ileocecal lesions. In this review, we discuss the use of imaging and endoscopic examinations for evaluation of ileocecal area to help ensure accurate diagnosis and appropriate treatment.

• Ileocecal lesions
• Imaging technology
• Endoscopic examination
• Diagnosis

Endoscopy in IBD has tremendous importance to diagnose inflammatory activity, to evaluate therapeutic success and for the surveillance of colitis associated cancer. Thus it becomes obvious that there is a need for new and more advanced endoscopic imaging techniques for better characterization of mucosal inflammation and early neoplasia detection in IBD. This paper describes the concept of advanced endoscopic imaging for the diagnosis and characterization of Crohn's disease, including magnification endoscopy, chromoendoscopy, balloon-assisted enteroscopy, capsule endoscopy, confocal laser endomicroscopy, and endocytoscopy.

Ulcerative colitis (UC) is a chronic disease featuring recurrent inflammation of the colonic mucosa. The goal of medical treatment is to rapidly induce a steroid-free remission while at the same time preventing complications of the disease itself and its treatment. The choice of treatment depends on severity, localization and the course of the disease. For proctitis, topical therapy with 5-aminosalicylic acid (5-ASA) compounds is used. More extensive or severe disease should be treated with oral and local 5-ASA compounds and corticosteroids to induce remission. Patients who do not respond to this treatment require hospitalization. Intravenous steroids or, when refractory, calcineurin inhibitors (cyclosporine, tacrolimus), tumor necrosis factor-α antibodies (infliximab) or immunomodulators (azathioprine, 6-mercaptopurine) are then called for. Indications for emergency surgery include refractory toxic megacolon, perforation, and continuous severe colorectal bleeding. Close collaboration between gastroenterologist and surgeon is mandatory in order not to delay surgical therapy when needed. This article is intended to give a general, practice-orientated overview of the key issues in ulcerative colitis treatment. Recommendations are based on published consensus guidelines derived from national and international guidelines on the treatment of ulcerative colitis.

• Ulcerative colitis
• Inflammatory bowel disease
• Medical management
• Diagnosis
• Azathioprine
• TNF-α blocker