小肠MR灌注成像定量参数对克罗恩病早期诊断及活动性评估的初步研究  

MRI Quantitative Parameters of Small-Bowel Perfusion for Early Diagnosing and Assessing Activity of Crohn’s Disease:A Preliminary Study

作　　者：吴吟晨 郑贤应[1] 曹代荣[1] 林雪花[1] 黄楠[1] 陈琦[1] 黄欣瑶 WU Yinchen;ZHENG Xianying;CAO Dairong(Department of Radiology,the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005,P.R.China)

机构地区：[1]福建医科大学附属第一医院影像科

出　　处：《临床放射学杂志》2018年第12期2022-2028,共7页Journal of Clinical Radiology

基　　金：2018年卫计委创新课题(编号:2018-CX-30)

摘　　要：目的应用小肠MR灌注成像技术对克罗恩病(CD)进行研究,探讨定量参数对比剂容积转运速率(Ktrans)、血浆与血管外细胞外间隙间的速率常数(Kep)及单位体积组织血管外细胞外间隙容积(Ve)与病变局部微血管灌注量及渗透性改变的关系,评价其对CD早期诊断及活动性评估的应用价值。方法搜集48例行磁共振小肠成像(MRE)检查及动态增强磁共振成像(DCE-MRI)扫描的CD患者,计算CD病灶区及正常肠壁区Ktrans、Kep及Ve值,并比较两个区域间参数值的差异。根据CD活动指数(CDAI)分期,将患者分为缓解期、轻度活动期及中重度活动期组,比较三组间Ktrans、Kep及Ve值的差异及其与CDAI评分、肠壁厚度值的相关性。结果 48例CD病灶区的Ktrans、Kep及Ve值明显高于正常肠壁(P均<0.05),其中CD病灶区Ve值约为正常肠壁区15倍,Ktrans值约为7倍。48例CD患者中,缓解期组13例,轻度活动期组20例,中重度活动期组15例。缓解期组Ktrans、Kep及Ve值低于活动期组(P均<0.05),随着活动性增加,Ktrans、Kep及Ve值亦增大(Ktrans值、Kep值、Ve值P均=0.000),三组中Kep值增大最显著。各参数值均与CDAI评分呈高度正相关性(P均<0.05)。但Ktrans值与肠壁厚度值相关性分析无统计学意义(P=0.471)。结论小肠MR灌注成像定量参数可反映CD病变局部血管灌注量及渗透性改变,对CD早期诊断及活动性评估有一定价值。Objective To explore the relationship between MRI quantitative parameters such as the volume transfer constant(Ktrans),the reflux constant(Kep) and the extravascular space volume fraction(Ve) and the change of blood perfusion and permeability of Crohn's Disease(CD),and evaluate the value of small-bowel for early diagnosing and assessing activity of CD.Methods 48 patients who underwent bowel examination with magnetic resonance enterography(MRE)were recruited.Ktrans,Kepand Veof normal and terminal small bowel were collected and compared.According to Crohn's disease activity index(CDAI),all patients were divided into three groups such as remissive group,mild group and moderate-severe group.The differences of Ktrans,Kepand Veamong the three groups were compared.The correlations between quantitative parameters and CDAI and small-bowel wall thickness were respectively evaluated.Results In 48 patients,Ktrans,Kepand Veof terminal small-bowel were higher significantly than that of normal bowel(P < 0.05) with the most remarkable increase in Ve.There were 13 cases of remissive group,20 cases of mild group and 15 cases of moderate-severe group.Ktrans,Kepand Veof remissive group were lower than active group(P < 0.05).With the progress of CD,Ktrans,Kep and Vealso increased(P = 0.000).All quantitative parameters had high positive correlation with CDAI(P < 0.05).However,it was not statistically significant in correlation between Ktransand small-bowel wall thickness.Conclusion MRI quantitative parameters of small-bowel perfusion can reflect the change of blood perfusion and permeability of CD,and have a certain value for early diagnosing and assessing activity of CD.

关 键 词：克罗恩病 磁共振小肠成像 动态增强磁共振成像 磁共振灌注成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R574.62[医药卫生—诊断学]