Langhorst Jost, Kühle Christiane A, Ajaj Waleed, Nüfer Michael, Barkhausen Jörg, Michalsen Andreas, Dobos Gustav J, Lauenstein Thomas C
Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Germany.
Inflamm Bowel Dis. 2007 Aug;13(8):1001-8. doi: 10.1002/ibd.20140.
The purpose of this pilot study was to assess the diagnostic accuracy of MR colonography (MRC) without bowel cleansing regarding its ability to quantify inflammatory bowel disease (IBD). In addition, patient acceptance was compared with conventional colonoscopy (CC).
In all, 29 patients with IBD (17 ulcerative colitis; 12 Crohn's disease) were included. While CC was performed after bowel cleansing as the gold standard, MRC was based on a fecal tagging technique and performed 48-72 hours prior to CC. The presence of inflammation in each of 7 ileocolonic segments was rated for every procedure. Patients evaluated both modalities and dedicated aspects of the examination according to a 10-point-scale (1 = good, 10 = poor acceptance). Furthermore, preferences for future examinations were investigated.
Inflammatory segments were found by means of CC in 23 and by MRC in 14 patients. Overall sensitivity and specificity of MRC in a segment-based detection were 32% and 88%, respectively. Concerning severely inflamed segments, sensitivity increased to 53% for MRC. Overall acceptance of CC was significantly higher compared to MRC (mean value (mv) for MRT = 6.0; CC = 4.1; P = 0.003). For MRC, the placement of the rectal tube (mv = 7.3), and for CC bowel purgation (mv = 6.5), were rated as the most unpleasant. A total of 67% of patients voted for CC as the favorable tool for future examinations.
The presented data indicate that 'fecal tagging MRC' is not suitable for an adequate quantification of inflammatory diseases of the large bowel. Furthermore, overall acceptance of endoscopic colonoscopy was superior to MRC.
本初步研究的目的是评估不进行肠道清洁的磁共振结肠成像（MRC）在量化炎症性肠病（IBD）方面的诊断准确性。此外，还将患者对MRC的接受度与传统结肠镜检查（CC）进行了比较。
共纳入29例IBD患者（17例溃疡性结肠炎；12例克罗恩病）。CC作为金标准在肠道清洁后进行，而MRC基于粪便标记技术，在CC前48 - 72小时进行。对每个检查程序，对7个回结肠段中的每一段的炎症情况进行评分。患者根据10分制（1 = 好，10 = 接受度差）对两种检查方式及检查的特定方面进行评估。此外，还调查了患者对未来检查的偏好。
通过CC发现23例患者存在炎症段，通过MRC发现14例。在基于段的检测中，MRC的总体敏感性和特异性分别为32%和88%。对于严重发炎的段，MRC的敏感性增至53%。CC的总体接受度显著高于MRC（MRT的平均值（mv）= 6.0；CC = 4.1；P = 0.003）。对于MRC，直肠管放置（mv = 7.3），对于CC肠道清洗（mv = 6.5），被评为最不舒服的环节。共有67%的患者选择CC作为未来检查的首选工具。
所呈现的数据表明，“粪便标记MRC”不适用于对大肠炎症性疾病进行充分量化。此外，内镜结肠镜检查的总体接受度优于MRC。
