Department of Gastroenterology, Nancy University Hospital, Lorraine University, Vandœuvre-lès-Nancy, France.
Department of Radiology, Nancy University Hospital, Lorraine University, Vandœuvre-lès-Nancy, France.
Dig Liver Dis. 2018 Oct;50(10):1012-1018. doi: 10.1016/j.dld.2018.06.024. Epub 2018 Jul 31.
Primary sclerosing cholangitis (PSC) is a major concern in inflammatory bowel disease (IBD).
Evaluating the use of magnetic resonance cholangiography (MRC) as a screening tool for PSC in IBD patients.
A single-center cohort study investigating systematic MRC to assess PSC in IBD patients with (cohort 1) and without (cohort 2) liver function tests (LFTs) abnormality, combined with a retrospective analysis of MRCs in a control group of non-IBD patients with abnormal LFTs (cohort 3).
In total, 420 patients (cohort 1: n = 203, cohort 2: n = 30, cohort 3: n = 187) underwent imaging. MRC was classified 'abnormal' in 49/203 (24.1%) patients in cohort 1, in 1/30 (3.3%) patients in cohort 2, and in 66/187 (35.3%) patients in cohort 3 (p < 0.004 for all comparisons). PSC was diagnosed in 20/203 (9.9%) patients in cohort 1, in 1/30 (3.3%) patients in cohort 2, and in 13/187 (7.0%) patients in cohort 3 (p = 0.44). Gamma-glutamyl transpeptidase was the only independent factor predicting the diagnosis of PSC in IBD (OR 1.8, 95% CI 1.3-2.5, p = 0.001).
MRC revealed PSC in one tenth of IBD patients with abnormal LFTs and should be systematically performed in IBD patients with abnormal LFTs, especially if gamma-glutamyl transpeptidase level is elevated.
原发性硬化性胆管炎（PSC）是炎症性肠病（IBD）的主要关注点。
评估磁共振胆胰管成像（MRC）作为 IBD 患者 PSC 的筛查工具的应用。
一项单中心队列研究，对 IBD 患者（队列 1）和无肝酶试验（LFTs）异常的 IBD 患者（队列 2）进行系统 MRC 评估以评估 PSC，并对 LFTs 异常的非 IBD 患者的 MRC 进行回顾性分析（队列 3）。
共有 420 名患者（队列 1：n=203，队列 2：n=30，队列 3：n=187）进行了影像学检查。在队列 1 中，49/203（24.1%）患者的 MRC 分类为“异常”，在队列 2 中，1/30（3.3%）患者的 MRC 分类为“异常”，在队列 3 中，187/187（35.3%）患者的 MRC 分类为“异常”（所有比较的 p 值均<0.004）。在队列 1 中诊断出 20/203（9.9%）患者患有 PSC，在队列 2 中诊断出 1/30（3.3%）患者患有 PSC，在队列 3 中诊断出 13/187（7.0%）患者患有 PSC（p=0.44）。谷氨酰转肽酶是唯一独立预测 IBD 患者 PSC 诊断的因素（OR 1.8，95%CI 1.3-2.5，p=0.001）。
MRC 在十分之一的 LFTs 异常的 IBD 患者中发现了 PSC，应在 LFTs 异常的 IBD 患者中系统地进行 MRC，尤其是当谷氨酰转肽酶水平升高时。
