Dinter Dietmar J, Chakraborty Anja, Brade Joachim, Back Walter, Neff K Wolfgang, Singer Manfred V, Böcker Ulrich
Institute of Clinical Radiology, University Hospital Mannheim, University of Heidelberg, Germany.
Scand J Gastroenterol. 2008;43(2):207-16. doi: 10.1080/00365520701676021.
There is ongoing debate about which imaging modality is best for patients with inflammatory bowel diseases. Magnetic resonance imaging (MRI) has been successfully used to evaluate the jejunum and the ileum. Because virtual colonoscopy by MRI requires bowel cleansing and/or rectal filling, endoscopy is preferred for assessment of the colon. However, hydro-MRI without special bowel preparation may be sufficient as a diagnostic tool if specifically targeted in the course of a known disease. The aim of this study was retrospectively to assess the correlation of endoscopy, histology and MRI findings for the terminal ileum and the colon in a cohort of patients with Crohn's disease.
In all, 60 patients with a confirmed diagnosis of Crohn's disease were included in the study. Here, 412 anatomical segments of the colon were analysed by MRI, 401 by endoscopy and 374 by histology.
Presence or absence of inflammation was concordantly diagnosed in 310 segments (77.3%). The highest concordance was found for the terminal ileum and, in patients with previous surgery, the anastomosis. Sensitivity and specificity for MRI versus endoscopy, MRI versus histology and endoscopy versus histology were 64.4%/81.1%, 62.1%/86.2% and 78.2%/80.3%, respectively.
In a retrospective analysis of patients with Crohn's disease, hydro-MRI assessment of inflammation in anatomical segments of the colon reaches acceptable concordance rates with endoscopy and histology without prior preparation of the bowel. The data justify a prospective controlled trial.
关于哪种成像方式对炎症性肠病患者最为适用，目前仍存在争议。磁共振成像（MRI）已成功用于评估空肠和回肠。由于MRI虚拟结肠镜检查需要肠道清洁和/或直肠充盈，因此评估结肠时首选内镜检查。然而，如果在已知疾病过程中进行特定靶向检查，无需特殊肠道准备的水成像MRI可能足以作为诊断工具。本研究的目的是回顾性评估一组克罗恩病患者末端回肠和结肠的内镜检查、组织学检查及MRI检查结果之间的相关性。
本研究共纳入60例确诊为克罗恩病的患者。其中，MRI分析了412个结肠解剖节段，内镜检查分析了401个节段，组织学检查分析了374个节段。
在310个节段（77.3%）中，炎症的有无诊断结果一致。末端回肠以及既往有手术史患者的吻合口处一致性最高。MRI与内镜检查、MRI与组织学检查以及内镜检查与组织学检查的敏感性和特异性分别为64.4%/81.1%、62.1%/86.2%和78.2%/80.3%。
在对克罗恩病患者的回顾性分析中，结肠解剖节段炎症的水成像MRI评估与内镜检查和组织学检查的符合率可接受，且无需事先进行肠道准备。这些数据证明有必要进行一项前瞻性对照试验。
Zotero 插件