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MRI 增强动力学测量评估克罗恩病的炎症活动。

Measurement of MRI enhancement kinetics for evaluation of inflammatory activity in Crohn's disease.

机构信息

Klinik für Strahlenheilkunde, Charité Campus Virchow-Klinikum, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.

出版信息

Clin Imaging. 2010 Jan-Feb;34(1):29-35. doi: 10.1016/j.clinimag.2009.03.008.

Abstract

PURPOSE

To investigate the feasibility of determining local inflammatory activity of Crohn's disease by measurement of bowel wall perfusion kinetics using contrast-enhanced magnetic resonance imaging (MRI).

MATERIAL AND METHODS

Twenty-six patients with histologically proven Crohn's disease who underwent magnetic resonance (MR) enteroclysis at 1.5 T were included in this retrospective study. Over 109 s, 150 images were acquired with a fat-saturated coronal T1-weighted 2D gradient echo sequence (TR, 9 ms; TE, 1.5 ms) during intravenous contrast administration by means of a pump (Magnevist, 0.2 ml/kg, flow 3 ml/s). On each image, signal intensity was measured in a region of interest placed in an area of maximum thickening of the inflamed bowel wall. Enhancement kinetics were correlated with the endoscopically determined severity of inflammatory activity (on a scale of 0-3).

RESULTS

The slope of the contrast enhancement curve significantly correlated with local inflammatory activity determined by endoscopy (R=0.594, P=.007). No significant correlation was found for area under the curve and peak maximum (R=0.411, P=.08 and R=0.334, P=.15, respectively).

CONCLUSION

Determination of the perfusion kinetics of the bowel wall by MRI enables quantitative evaluation of local inflammatory activity in patients with Crohn's disease.

摘要

目的

通过对比增强磁共振成像(MRI)测量肠壁灌注动力学,来研究确定克罗恩病局部炎症活性的可行性。

材料与方法

本回顾性研究纳入了 26 名经组织学证实患有克罗恩病并在 1.5T 磁共振(MR)肠造影的患者。在静脉注射造影剂(Magnevist,0.2ml/kg,流速 3ml/s)期间,使用脂肪饱和冠状 T1 加权 2D 梯度回波序列(TR,9ms;TE,1.5ms),在 109 秒内获取了 150 张图像。在每个图像上,在发炎肠壁增厚最大的区域中,通过放置感兴趣区域来测量信号强度。增强动力学与内窥镜确定的炎症活动严重程度(0-3 级)相关。

结果

对比增强曲线的斜率与内窥镜确定的局部炎症活性显著相关(R=0.594,P=.007)。而曲线下面积和峰值最大的相关性没有统计学意义(R=0.411,P=.08 和 R=0.334,P=.15)。

结论

通过 MRI 确定肠壁的灌注动力学,可以定量评估克罗恩病患者的局部炎症活性。

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