Perianal fistulizing Crohn's disease (pfCD) represents a severe manifestation of Crohn's disease (CD) that often leads to significant morbidity. Clinical examination alone of perianal fistulae is unlikely to be sufficient in the context of complex pfCD, as patients are likely to have complex disease and are more likely to experience complications, treatment failure, and recurrent disease. Furthermore, the relapsing-remitting nature of Crohn's disease and our limited understanding of the pathogenesis of this potentially destructive disease necessitate regular examination and radiological assessment, often in the form of magnetic resonance imaging (MRI). Recent advancements in diagnostic techniques have enhanced the accuracy and timeliness of pfCD diagnosis, facilitating better patient outcomes. A growing appreciation of isolated perianal Crohn's disease has prompted a recent attempt to develop consensus recommendations on diagnosing and treating this group of patients who would previously not have been offered CD medications. This narrative review aims to summarize current practice and the latest developments in the diagnosis of pfCD, highlighting: 1. Clinical examination and assessment tools 2. Current imaging practices 3. Innovations in imaging and biomarkers 4. The diagnosis of isolated perianal Crohn's disease.

Keywords: Diagnosis; Fistula; Perianal Crohn’s disease; Radiology.

© 2025. The Author(s).

会阴部瘘管性克罗恩病（pfCD）是克罗恩病（CD）的一种严重表现形式，常常导致显著的疾病负担。对于复杂的会阴部瘘管性克罗恩病而言，仅靠临床检查可能不足以充分评估病情，因为患者通常患有复杂性疾病，并且更容易出现并发症、治疗失败和复发。此外，由于克罗恩病反复发作的特点以及我们对该潜在破坏性疾病发病机制了解有限，定期进行检查和放射学评估（通常是磁共振成像MRI）是必要的。最近在诊断技术方面的进步提高了pfCD诊断的准确性和及时性，从而改善了患者的预后效果。对于孤立性会阴部克罗恩病的认识逐渐增加，促使人们试图为这一类以前未提供CD药物治疗的患者制定共识建议。本叙述性综述旨在总结目前诊断pfCD的实践和最新进展，重点关注以下几点：
1. 临床检查与评估工具
2. 当前影像学实践
3. 影像学及生物标志物创新
4. 孤立性会阴部克罗恩病的诊断

关键词：诊断；瘘管；会阴部克罗恩病；放射学。

© 2025. 作者保留所有权利。