Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Eur J Radiol. 2011 Dec;80(3):e299-305. doi: 10.1016/j.ejrad.2010.12.075. Epub 2011 Feb 4.
To retrospectively compare histopathological findings of surgically resected bowel segments with magnetic resonance imaging (MRI) findings on Crohn's disease activity.
Patients who underwent a MR enterography or enteroclysis before surgery were included after informed consent. MRI features (T1-enhancement, T1 and T2 stratification, T2 signal intensity, bowel wall thickness, presence of ulcerations, comb sign, creeping fat, and disease activity) were assessed by three experienced abdominal radiologists. An acute inflammatory score based on histopathology (parameters: mucosal ulceration, edema, depth and degree of neutrophils) was calculated. Interobserver variability for subjective MRI features was also assessed.
Thirty-nine segments in 25 patients (mean age 38 years) were included. Of the MRI features, disease activity per segment and bowel wall thickness had a positive association with the acute inflammatory score (p<0.05). T1-enhancement had a positive correlation with disease chronicity. All other MRI features did not have an association with the acute inflammatory score. Interobserver agreement between the three observers was weak to moderate.
MR features bowel wall thickness and disease activity per-segment reflect disease activity in Crohn's disease patients.
回顾性比较经手术切除肠段的组织病理学发现与磁共振成像（MRI）在克罗恩病活动中的表现。
在获得知情同意后，纳入了术前接受 MR 肠造影或肠灌洗的患者。由三位经验丰富的腹部放射科医生评估 MRI 特征（T1 增强、T1 和 T2 分层、T2 信号强度、肠壁厚度、溃疡存在、梳状征、匍匐脂肪和疾病活动）。根据组织病理学计算急性炎症评分（参数：黏膜溃疡、水肿、中性粒细胞的深度和程度）。还评估了主观 MRI 特征的观察者间变异性。
25 名患者的 39 个肠段（平均年龄 38 岁）被纳入研究。在 MRI 特征中，每段疾病活动度和肠壁厚度与急性炎症评分呈正相关（p<0.05）。T1 增强与疾病慢性度呈正相关。其他 MRI 特征与急性炎症评分均无关联。三位观察者之间的观察者间一致性为弱到中度。
MR 特征肠壁厚度和每段疾病活动度反映了克罗恩病患者的疾病活动度。
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