Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Department of Radiology, Seoul National University College of Medicine (Baltimore), 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Eur Radiol. 2020 Jun;30(6):3168-3177. doi: 10.1007/s00330-020-06684-1. Epub 2020 Feb 20.
To evaluate the clinical usefulness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in children and young adults with Crohn's disease.
From August 2017 to October 2018, 30 patients with Crohn's disease (21 males and 9 females; mean age 15.1 ± 2.5 years) underwent DCE-MRI with MRI enterography. We assessed the endoscopic finding, pediatric Crohn's disease activity index (PCDAI), C-reactive protein (CRP) level (mg/dL), Crohn's disease MR index (CDMI) score, and the perfusion parameters of DCE-MRI (K, K, and V) at the ileocecal region between the inactive and active groups based on the histopathologic status.
The active Crohn's disease group showed higher PCDAI, CRP, and CDMI scores than the inactive group (22.2 ± 18.8 vs. 6.3 ± 6.4, p = 0.027; 1.32 ± 1.79 vs. 0.10 ± 0.13, p = 0.005; 7.4 ± 3.9 vs. 4.5 ± 3.0, p = 0.047, respectively). The active Crohn's disease group showed a higher K value than the inactive group (0.31 ± 0.12 vs. 0.16 ± 0.46 min, p = 0.002). Endoscopic finding; PCDAI, CRP, and CDMI scores; and K value were significant parameters in the identification of the active Crohn's disease (p = 0.002, p < 0.001, p = 0.029, p = 0.006, and p < 0.001, respectively). K value was the most significant value for identifying active Crohn's disease in the multivariate logistic regression analysis (p = 0.013).
K value could discriminate between inactive and active Crohn's diseases. K value may have the potential to monitor the pediatric Crohn's disease activity.
• With dynamic contrast-enhanced MRI, we can quantitatively monitor the Crohn's disease status in pediatric patients and provide proper management plans to clinicians. • The Kvalue of dynamic contrast-enhanced MRI perfusion parameter, as well as the clinical pediatric Crohn's disease activity index, C-reactive protein level, the endoscopic score, and the Crohn's disease MR index, was higher in the active Crohn's disease than in the inactive group based on the histopathologic status. • The Kvalue among the dynamic contrast-enhanced MRI perfusion parameters was the most significant differentiating parameter for the active Crohn's disease from inactive status among those parameters (p = 0.013).
评估动态对比增强磁共振成像（DCE-MRI）在儿童和青少年克罗恩病中的临床应用价值。
2017 年 8 月至 2018 年 10 月，30 例克罗恩病患者（男 21 例，女 9 例；平均年龄 15.1±2.5 岁）接受 MRI 肠造影术的 DCE-MRI 检查。我们根据组织病理学状态，评估内镜发现、儿童克罗恩病活动指数（PCDAI）、C 反应蛋白（CRP）水平（mg/dL）、克罗恩病磁共振指数（CDMI）评分，以及回肠末端的 DCE-MRI 灌注参数（K、K 和 V）。
活动期克罗恩病组的 PCDAI、CRP 和 CDMI 评分均高于缓解期（22.2±18.8 与 6.3±6.4，p=0.027；1.32±1.79 与 0.10±0.13，p=0.005；7.4±3.9 与 4.5±3.0，p=0.047）。活动期克罗恩病组的 K 值高于缓解期（0.31±0.12 与 0.16±0.46 min，p=0.002）。内镜发现、PCDAI、CRP 和 CDMI 评分、K 值均为识别活动期克罗恩病的显著参数（p=0.002、p<0.001、p=0.029、p=0.006 和 p<0.001）。多变量逻辑回归分析显示，K 值是识别活动期克罗恩病最显著的指标（p=0.013）。
K 值可区分克罗恩病的活动期和缓解期。K 值可能有潜力用于监测儿科克罗恩病的活动。
