Division of Gastroenterology, Hepatology and Nutrition, University of Florida College of Medicine, Gainesville, FL, USA.
Division of Gastroenterology, Hepatology and Nutrition, University of Florida College of Medicine, Gainesville, FL, USA.
Eur J Radiol. 2019 Sep;118:264-270. doi: 10.1016/j.ejrad.2019.08.001. Epub 2019 Aug 2.
A multiphasic cine sequence performed during magnetic resonance enterography (MRE) has been shown to increase diagnostic accuracy of MRE demonstrating limited movement in inflamed intestine in patients with Crohn's disease (CD). Our aim was to confirm in our study population that intestinal inflammation was associated with decreased motility and determine if factors suggestive of complicated disease such as the presence of a stricture or fistula were associated with decreased motility on the MRE cine sequence.
This was a retrospective study of 59 patients (mean age 40.8 ± 16.1) with Crohn's disease who had a small bowel lesion on MRE. Two gastrointestinal radiologists independently scored MRE findings using a qualitative, subjective scoring system. Univariate and multivariable ordered logistic regression models were used to evaluate the associations between cine sequence score, radiologic image findings, and clinical data.
On univariate analysis, radiologic findings reflecting active inflammation, the presence of a stricture, and penetrating disease were associated with decreased motility. On multivariable analysis, hyper-enhancement, the presence of a comb sign, and global evidence of active inflammation remained associated with decreased motility. Of the factors suggesting complicated disease, the presence of stricture (Odds Ratio 0.40, 95% Confidence Interval 0.17-0.95, p-value 0.038) was associated with decreased motility.
As previously shown, well-established radiologic findings of bowel inflammation were associated with decreased small bowel motility. In this study, we have added that the radiologic finding of a fixed stricture is also associated with decreased motility.
磁共振肠造影（MRE）中的多期电影序列已被证明可提高对克罗恩病（CD）患者炎症肠道有限运动的 MRE 诊断准确性。我们的目的是在我们的研究人群中证实肠道炎症与运动减少有关，并确定是否存在狭窄或瘘管等提示复杂疾病的因素与 MRE 电影序列上的运动减少有关。
这是一项对 59 例（平均年龄 40.8±16.1）小肠病变 MRE 的 CD 患者的回顾性研究。两名胃肠放射科医生使用定性、主观评分系统独立对 MRE 结果进行评分。使用单变量和多变量有序逻辑回归模型评估电影序列评分、放射图像发现和临床数据之间的关联。
在单变量分析中，反映活跃炎症、存在狭窄和穿透性疾病的放射学发现与运动减少有关。在多变量分析中，高增强、梳状征的存在和活跃炎症的整体证据与运动减少有关。在提示复杂疾病的因素中，狭窄的存在（优势比 0.40，95%置信区间 0.17-0.95，p 值 0.038）与运动减少有关。
正如先前所示，公认的肠道炎症放射学发现与小肠运动减少有关。在这项研究中，我们还发现固定狭窄的放射学发现也与运动减少有关。
