磁共振肠道造影对炎性肠病的诊断价值  

The diagnostic evaluation of magnetic resonance enteroclysis in inflammatory bowel disease

作　　者：叶心然 廖坚[2] 叶斌[2] 张声旺[2] Ye Xinran;Liao Jian;Ye Bin;Zhang Shengwang(Xiangya School of Public Health, Central South University, Changsha 410078, China;Department of Radiology ,the Third Xiangya Hospital, Central South University Changsha 410013, China)

机构地区：[1]中南大学湘雅公共卫生学院,长沙410078 [2]中南大学湘雅三医院放射科,长沙410013

出　　处：《中国医师杂志》2019年第6期862-865,871,共5页Journal of Chinese Physician

摘　　要：目的探讨磁共振肠道造影(MRE)在炎性肠病(IBD)中的诊断效能和图像质量的评估。方法回顾性分析在湘雅三医院拟诊为炎性肠病并行MRE检查的132例患者。将患者的MRE表现与手术及内窥镜获得的组织病理学结果进行比较,计算灵敏度、特异度和诊断符合率。并使用四分法评估MRE的图像质量。结果 MRE诊断炎性肠病的灵敏度、特异度和诊断符合率分别为94. 3%、92. 6%和93. 9%,其中2例患者假阳性,6例患者假阴性。根据评估标准一共评估了 530个小肠段MRE图像质量。其中,323个(61%)的图像质量得分为1,170个(32%)得分为2,29个(5.5%)得分为3,8个(1.5%)得分为4。观察者对所有肠管节段的图像质量评分和IBD评估的一致性很好(κ=0.73),远端回肠(1. 12)和末端回肠(1. 15)的区段中图像质量分数最高,十二指肠(1.92)和空肠(1.6)段的图像质量分数最低。结论 MRE在诊断炎性肠病中具有较高的诊断符合率,并能提供优异的图像质量。Objective This study aims to investigate diagnosis accuracy of magnetic resonance enteroclysis (MRE) and evaluation of image quality in inflammatory bowel disease (IBD). Methods A total of 132 patients were assumed inflammatory bowel disease and their MRE were retrospectively evaluated. Imaging feature of MRE and histopathologic results by surgery and endoscope were compared. The sensitivity, specificity and diagnostic performance were calculated and image quality of MRE were evaluated by using the quadrature method. Results A total of 530 small intestine segments were analyzed according to evaluation criteria. Imaging quality of 323 , 170, 29 and 8 small intestine segments were graded 1,2,3 and 4 respectively. Consistency for scoring of imaging quality and evaluation of IBD in intestine segments between observers was pretty good ( κ = 0. 73). Scoring of imaging quality was the highest in distal ileum ( 1. 12) and terminal ileum( 1. 15) and scoring was the lowest in duodenum (1. 92) and jejunum(1.6). The sensitivity ,specificity and diagnostic agreement rate of MRE in inflammatory bowel disease were 94. 3%, 92. 6% and 94. 7% respectively, including 2 false positive and 6 false negative result. Conclusions MRE can provide high performance in diagnosis of inflammatory bowel disease and good image quality.

关 键 词：炎性肠疾病 结肠炎 溃疡性 CROHN病 造影剂 X线透视检查 磁共振成像 

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]