3.0 T磁共振小肠成像在Crohn病活动性评估与随访中的应用价值  

The Application Value of 3.0 T Magnetic Resonance Enterography in Assessment and Follow-up of Crohn’s Disease Activity

作　　者：林雪花[1] 郑贤应[1] 曹代荣[1] 游瑞雄[1] 佘德君[1] 陈潭辉[1] 吴吟晨 黄欣瑶 陈琦[1] 

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1期89-93,共5页Journal of Clinical Radiology

摘　　要：目的探讨3.0T磁共振小肠成像（MRE）在Crohn病（CD）活动性评估与随访中的应用价值。方法回顾性分析经临床确诊为CD的26例患者61次MRE检查,通过MRE评分评估CD活动性,采用Spearman法分析MRE评分与Crohn病活动指数（CDAI）分、C反应蛋白（CRP）之间的相关性;随访临床治疗过程中MRE评分变化,并与相应CDAI评分变化、CRP变化进行相关性分析。结果 MRE评分为（12.49±5.31）分,CDAI评分为（134.82±88.15）分,CRP为（21.26±25.71）mg/L。MRE评分与CRP（r=0.764,P〈0.001）及CDAI评分（r=0.662,P〈0.001）均呈中度正相关;临床治疗过程中MRE变化与CDAI评分变化（r=0.678,P〈0.001）、CRP变化（r=0.554,P〈0.001）呈中度正相关。MRE动态随访CD过程中发现增厚的肠壁明显变薄、强化程度减低、T_2WI肠壁信号降低、肠周液性渗出的吸收、梳样征的消失、瘘管缩小或消失等征象均是活动度下降的指标。结论 3.0T磁共振小肠成像较好的评估CD活动性并随访CD活动性变化,推荐做为CD随访的常规影像学检查。Objective To explore the application value of 3.0T magnetic resonance enterography （MRE） in assessment and follow-up of Crohng disease （CD） activity. Methods Sixty-one MRE examinations of twenty-six patients who were clinically diagnosed with CD were retrospectively analyzed. The MRE scores of patients were calculated to evaluate CD ac- tivity. The correlation between the MRE scores and Crohng disease activity index（ CDAI）, CRP index was analyzed respec- tively by using the Spearman correlation test. The MRE scores changes of patients were recorded during clinical treatment. The correlation analysis between the MRE scores changes and CDAI index changes, CRP index changes was performed respectively. Results The MRE scores, CDAI and CRP index of patients were 12.49 ±5.31,134.82 ± 88.15 and 21.26 ± 25.71 mg/L,respectively. The correlation between MRE scores and CRP index（r =0. 764 ,P 〈0.001 ） ,CDAI （r =0. 662, P 〈0.001） was moderate respectively. The correlation between MRE score changes and CDAI changes （r =0. 678,P 〈 0.001 ） ,CRP index changes （r =0. 554,P 〈0. 001 ） was also moderate respectively. The MRE signs included the reduction of thickness and enhancement degree of the intestinal wall, the decrease of the signal intensity of the intestinal wall in T2WI, absorption of perienteritis, disappearance of comb sign and lessen or disappearance of fistula were indicative of the decrease of CDg activity. Conclusion 3.0 T magnetic resonance enterography is effective in assessment and follow-up of Crohng disease activity,which is recommended as a preferred examination in the follow up of CD patients.

关 键 词：克罗恩病 磁共振小肠成像 活动性 

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