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克罗恩病的检测:同一天不使用抗蠕动剂进行 CT 和 MR 肠造影的比较。

Detection of Crohn's disease: Comparison of CT and MR enterography without anti-peristaltic agents performed on the same day.

机构信息

Department of Diagnostic Imaging, Warren Alpert School of Medicine, Brown University, 593 Eddy St., Providence, RI 02903, United States.

出版信息

Eur J Radiol. 2012 Aug;81(8):1735-41. doi: 10.1016/j.ejrad.2011.04.068. Epub 2011 Jun 8.

DOI:10.1016/j.ejrad.2011.04.068
PMID:21645982
Abstract

OBJECTIVE

To directly compare CT enterography (CTE) and MR enterography (MRE) without antiperistaltic agents.

MATERIALS/METHODS: 26 patients referred for CTE underwent CTE immediately followed by MRE without use of an anti-peristaltic agent. Each study was evaluated on a 10 point scale for exam quality, level of diagnostic confidence, and presence of Crohn's disease. Kappa analysis was performed to determine the degree of agreement between the CTE and MRE of each patient.

RESULTS

25 patients completed the MRE. The quality of the CTEs was judged as excellent by both readers (reader 1=average 9.5/10, reader 2=average 9.1/10). The quality of the MREs was ranked lower than the CTEs by both readers (reader 1=average 8.9/10, reader 2=average 7.2/10), which was statistically significant (p<0.05). The level of confidence in interpretation was not significantly different between CTE and MRE for reader 1 or 2 (p=0.3). There was substantial agreement between readers for the presence or absence of Crohn's disease on both CTE (kappa=0.75) and MRE (kappa=0.67).

CONCLUSION

MR enterography without anti-peristaltic agents results in high diagnostic confidence and excellent agreement for the presence of Crohn's disease.

摘要

目的

直接比较 CT 肠造影(CTE)和磁共振肠造影(MRE),且不使用抗蠕动剂。

材料/方法:26 例因 CTE 而转诊的患者立即进行 CTE 检查,然后在不使用抗蠕动剂的情况下进行 MRE。每个研究都按照 10 分制进行评估,以评估检查质量、诊断信心水平和是否存在克罗恩病。采用 Kappa 分析来确定每位患者的 CTE 和 MRE 之间的一致性程度。

结果

25 例患者完成了 MRE。两位读者均认为 CTE 的质量非常好(读者 1=平均 9.5/10,读者 2=平均 9.1/10)。两位读者均认为 MRE 的质量低于 CTE(读者 1=平均 8.9/10,读者 2=平均 7.2/10),差异具有统计学意义(p<0.05)。读者 1 和 2 在解释的信心水平方面,CTE 和 MRE 之间无显著差异(p=0.3)。对于存在或不存在克罗恩病,两位读者在 CTE(kappa=0.75)和 MRE(kappa=0.67)上的一致性都很高。

结论

不使用抗蠕动剂的 MRE 可获得高诊断信心和对克罗恩病的存在具有极好的一致性。

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