Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
Inflamm Bowel Dis. 2011 May;17(5):1063-72. doi: 10.1002/ibd.21510. Epub 2010 Oct 25.
We developed novel magnetic resonance enterocolonography (MREC) for simultaneously evaluating both small and large bowel lesions in patients with Crohn's disease (CD). The aim of this study was to evaluate the diagnostic performance of MREC by comparing results of this procedure to those of endoscopies for evaluating the small and large bowel lesions of patients with CD.
Thirty patients with established CD were prospectively examined by newly developed MREC. Patients underwent ileocolonoscopy (ICS) (24 procedures) or double-balloon endoscopy (DBE) (10 procedures) after MREC on the same day. Two gastroenterologists and two radiologists who were blinded to the results of another study evaluated endoscopy and MREC findings, respectively.
In colonic lesions the sensitivities of the MREC for deep mucosal lesions (DML), all CD lesions, and stenosis were 88.2, 61.8, and 71.4%, respectively, while the specificities were 98.1, 95.3, and 97.7%, respectively. In small intestinal lesions, MREC sensitivities for DML, all CD lesions, and stenosis were 100, 85.7, and 100%, respectively, while specificities were 100, 90.5, and 93.1%, respectively. Endoscopic scores were significantly correlated with MREC scores. Eleven (46%) of the 24 patients who were clinically not suspected to show stricture were observed to demonstrate stricture by radiologists.
Our results demonstrated that MREC can simultaneously detect the CD lesions of the small and large intestine. MREC can be performed without radiation exposure, the use of enema, or the placement of a naso-jejunal catheter. MREC and endoscopy have comparable abilities for evaluating mucosal lesions of patients with CD.
我们开发了一种新的磁共振肠造影术（MREC），用于同时评估克罗恩病（CD）患者的小肠和大肠病变。本研究旨在通过比较 MREC 与内镜检查对 CD 患者小肠和大肠病变的评估结果，来评估 MREC 的诊断性能。
30 例确诊为 CD 的患者前瞻性地接受了新开发的 MREC 检查。患者在 MREC 检查后当天接受了回结肠镜检查（ICS）（24 例）或双气囊内镜检查（DBE）（10 例）。两位胃肠病学家和两位放射科医生分别对内镜和 MREC 检查结果进行了评估，他们对另一项研究的结果不知情。
在结肠病变中，MREC 对深部黏膜病变（DML）、所有 CD 病变和狭窄的敏感度分别为 88.2%、61.8%和 71.4%，特异度分别为 98.1%、95.3%和 97.7%。在小肠病变中，MREC 对 DML、所有 CD 病变和狭窄的敏感度分别为 100%、85.7%和 100%，特异度分别为 100%、90.5%和 93.1%。内镜评分与 MREC 评分显著相关。24 例临床不怀疑有狭窄的患者中，有 11 例（46%）被放射科医生观察到有狭窄。
我们的结果表明，MREC 可以同时检测小肠和大肠的 CD 病变。MREC 可以在不暴露于辐射、不使用灌肠或放置鼻空肠导管的情况下进行。MREC 和内镜在评估 CD 患者的黏膜病变方面具有相当的能力。
