T2~* mapping评估克罗恩病炎症活动性的应用研究  

Application Research of T2~* Mapping in Evaluating Inflammatory Activity in Crohn Disease

作　　者：黄斯韵[1] 李雪华[1] 方壮念 张梦晨 冯仕庭[1] 孙灿辉[1] 李子平[1] 林少春[1] HUANG Si-yun LI Xue-hua FANG Zhuang-nian ZHANG Meng-chen FENG Shi-ting SUN Can-hui LI Zi-ping LIN Shao-chun(Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China)

机构地区：[1]中山大学附属第一医院放射科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2017年第5期759-764,773,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(81600508);广东省科技计划项目(2017A020215013;2014A020212480)

摘　　要：【目的】探讨T2~* mapping对评估克罗恩病(CD)炎症活动性的应用价值。【方法】98例CD患者行MR肠道造影及T2~*WI扫描。在T2~*mapping上测量病变肠壁的T2~*值,以MR活动性指数(MaRIA)为CD炎症活动性的参考标准,分析T2~*值与CD活动性的关系。【结果】160个肠段中,缓解期CD(Ma RIA<7)26段,轻度活动期CD(7≤Ma RIA<11)23段,中-重度活动期(MaRIA≥11)111段。三组CD肠壁的T2~*值差异有统计学意义(均P<0.05)。160个肠段的T2~*值与Ma RIA具有较好的相关性(r=0.743,P<0.05)。ROC曲线分析显示T2~*值在鉴别缓解期和活动期CD(AUC=0.877)以及鉴别缓解期-轻度活动期和中-重度活动期CD(AUC=0.848)均具有较高的诊断准确性,其中T2~*值选择阈值为20 ms时诊断轻度和中-重度活动期CD的敏感性为74.5%,特异性为84%。【结论】T2~*mapping的定量指标T2~*值与CD活动性有较好的相关性,可准确诊断CD的炎症活动性。【Objective】To explore the efficacy of T2^＊ mapping for evaluating inflammatory activity in the patients with Crohn disease（CD）.【Methods】A total of 98 CD patients underwent MR enterographywith T2^＊WI. T2^＊ values were measured by putting regions of interest on the thickening bowel wall on T2^＊mapping. The activity of bowel segment was scored by magnetic resonance index of activity（Ma RIA）,to analyze the relationship between T2^＊values with CD activity.【Results】A total of 160 bowel segments were evaluated and includedinactive（Ma RIA 7,n = 26）,mild（7 ≤ Ma RIA 11,n = 23）,and moderately-severe（Ma RIA ≥ 11,n = 111）active lesions. The differences in T2^＊values amongthese three groups were significant（all P〈0.05）. T2^＊values of 160 bowel segments correlatedclosely with Ma RIA（r = 0.743,P〈0.05）. High accuracy of T2^＊values was shown for differentiating inactive from active CD（AUC=0.877）anddifferentiating inactive-mild from moderate-severe CD（AUC = 0.848）. The threshold T2^＊value of 20 ms allowed differentiation of mild from moderate-severe CD with74.5% sensitivity and 84% specificity.【Conclusions】T2^＊values,as thequantitative indexof T2^＊mapping,correlate well with CD activity and showsatisfiedefficacy for diagnosing inflammatoryactivity.

关 键 词：T2^＊ MAPPING 磁共振肠道造影 克罗恩病 MaRIA 

分 类 号：R445.2[医药卫生—影像医学与核医学]