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磁共振小肠造影在克罗恩病诊断中的应用价值

Usefulness of magnetic resonance enterography in diagnosis of Crohn's disease.

作者信息

Gmerek Łukasz, Katulska Katarzyna, Horbacka Karolina, Krokowicz Piotr

机构信息

Department and Clinic of General and Colorectal Surgery, Medical University in Poznań.

出版信息

Pol Przegl Chir. 2011 May;83(5):244-9. doi: 10.2478/v10035-011-0038-0.

Abstract

UNLABELLED

The numbers of patients with diagnosed Crohn's disease in Poland continue to be on the rise. It may be assumed that it is associated not with an increased incidence but with significant advancements in diagnostic techniques which in an increasingly better manner solve problems of abdominal pain. One of such methods is magnetic resonance enterography, which gives high hope in the diagnostics of Crohn's disease. The aim of the study was the evaluation of the results of magnetic resonance enterography (MREG) and their comparison with the results of histopathological examination o perioperative specimens.

MATERIAL AND METHODS

The clinical material comprised 48 patients with suspected Crohn's disease. Colonoscopy was performed in all the patients, followed by magnetic resonance enterography, which evaluated the lesion localisation, large intestine wall thickening, small intestine stenosis, mesenteric vessel proliferation, infiltration of surrounding adipose tissue, lymph node enlargement, presence of enteroenteral, enterovesical and enterocutaneous fistulas. Next, a surgical procedure was performed, with collection of specimen for histopathology. The examination results were compared with those of magnetic resonance enterography.

RESULTS

MREG was performed in 48 individuals. Suspected Crohn's disease based on the above examination was diagnosed in 35 cases, isolated small intestine inflammation--in 5, and fibrosis in the remaining 5 patients. No significant differences were found between the lesion localisation done by MREG or perioperativelly. Crohn's disease was confirmed by histopathology in 36 cases. The sensitivity of MREG with histopathology was 91.6%, and the specificity--77.8%.

CONCLUSIONS

Magnetic resonance enterography is a highly effective and sensitice method in the diagnostics of Crohn's disease, free of adverse effects and possible to be performed even in pregnant female patients.

摘要

未标注

波兰确诊克罗恩病的患者数量持续上升。可以推测,这并非与发病率上升有关,而是与诊断技术的显著进步有关,这些技术能越来越好地解决腹痛问题。其中一种方法是磁共振小肠造影,它在克罗恩病的诊断中寄予厚望。本研究的目的是评估磁共振小肠造影(MREG)的结果,并将其与围手术期标本的组织病理学检查结果进行比较。

材料与方法

临床资料包括48例疑似克罗恩病的患者。所有患者均接受了结肠镜检查,随后进行磁共振小肠造影,评估病变定位、大肠壁增厚、小肠狭窄、肠系膜血管增生、周围脂肪组织浸润、淋巴结肿大、肠肠瘘、肠膀胱瘘和肠皮肤瘘的存在情况。接下来进行手术,采集标本进行组织病理学检查。将检查结果与磁共振小肠造影的结果进行比较。

结果

48例患者进行了磁共振小肠造影。根据上述检查,35例诊断为疑似克罗恩病,5例为孤立性小肠炎症,其余5例为纤维化。磁共振小肠造影或围手术期确定的病变定位之间未发现显著差异。组织病理学确诊克罗恩病36例。磁共振小肠造影与组织病理学检查的敏感性为91.6%,特异性为77.8%。

结论

磁共振小肠造影是诊断克罗恩病的一种高效、敏感的方法,无不良反应,甚至对孕妇也可进行。

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