Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
World J Gastroenterol. 2018 Jun 7;24(21):2279-2290. doi: 10.3748/wjg.v24.i21.2279.
To examine the correlation between magnetic resonance imaging (MRI) and endoscopic index of severity (CDEIS) in patients with Crohn's disease (CD).
This was a retrospective study of 104 patients with CD that were treated at the Ruijin Hospital between March 2015 and May 2016. Among them, 61 patients with active CD were evaluated before/after treatment. MRI and endoscopy were performed within 7 d. CDEIS was evaluated. MRI parameters included MaRIA scores, total relative contrast enhancement (tRCE), arterial RCE (aRCE), portal RCE (pRCE), delay phase RCE (dRCE), and apparent diffusion coefficient. The correlation and concordance between multiple MRI findings and CDEIS changes before and after CD treatment were examined.
Among the 104 patients, 61 patients were classified as active CD and 43 patients as inactive CD. Gender, age, disease duration, and disease location were not significantly different between the two groups (all > 0.05). CRP levels were higher in the active group than in the inactive group (25.12 ± 4.12 5.14 ± 0.98 mg/L, < 0.001). Before treatment, the correlations between CDEIS and MaRIAs in all patients were = 0.772 for tRCE, = 0.754 for aRCE, = 0.738 for pRCE, and = 0.712 for dRCE (all MaRIAs, < 0.001), followed by MRI single indexes. Among the active CD patients, 44 cases were remitted to inactive CD after treatment. The correlations between CDEIS and MaRIAs were = 0.712 for aRCE, = 0.705 for tRCE, = 0.685 for pRCE, and = 0.634 for dRCE (all MaRIAs, < 0.001).
Arterial MaRIA should be an indicator for CD follow-up and dynamic assessment. CD treatment assessment was not completely concordant between CDEIS and MRI.
探讨磁共振成像（MRI）与克罗恩病（CD）内镜严重指数（CDEIS）之间的相关性。
这是一项回顾性研究，纳入了 2015 年 3 月至 2016 年 5 月在瑞金医院接受治疗的 104 例 CD 患者。其中，61 例活动期 CD 患者在治疗前后进行了评估。MRI 和内镜检查均在 7 天内完成。评估 CDEIS。MRI 参数包括 MaRIA 评分、总相对对比增强（tRCE）、动脉 RCE（aRCE）、门脉 RCE（pRCE）、延迟相 RCE（dRCE）和表观扩散系数。检测治疗前后 CD 患者多种 MRI 指标与 CDEIS 变化的相关性和一致性。
104 例患者中，61 例为活动期 CD，43 例为缓解期 CD。两组患者的性别、年龄、病程和病变部位差异均无统计学意义（均>0.05）。活动期 CD 患者的 CRP 水平高于缓解期 CD 患者（25.12±4.12比 5.14±0.98 mg/L，<0.001）。治疗前，所有患者的 CDEIS 与 MaRIAs 的相关性分别为 tRCE 的 r=0.772、aRCE 的 r=0.754、pRCE 的 r=0.738 和 dRCE 的 r=0.712（均<0.001），其次为 MRI 单一指标。在活动期 CD 患者中，44 例患者经治疗后缓解为缓解期 CD。治疗后 CDEIS 与 MaRIAs 的相关性分别为 aRCE 的 r=0.712、tRCE 的 r=0.705、pRCE 的 r=0.685 和 dRCE 的 r=0.634（均<0.001）。
动脉 MaRIA 应作为 CD 随访和动态评估的指标。CDEIS 与 MRI 对 CD 治疗评估不完全一致。
