2nd Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Wroclaw, Poland.
Diagnostic Imaging Laboratory, Cooper Health Center, Lublin, Poland.
Adv Med Sci. 2020 Mar;65(1):214-222. doi: 10.1016/j.advms.2020.01.005. Epub 2020 Feb 20.
Crohn's disease (CD) is a chronic inflammatory disease which can affect all parts of the gastrointestinal tract. Magnetic resonance enterography (MRE) enables detection of pathologic changes in the small intestine, which are not accessible by conventional endoscopy. The aim of the study was to assess the value of MRE in imaging of small bowel lesions, their location and extent, in CD patients and its correlation with clinical and endoscopic activity.
MRE was performed in 108 children with CD, aged 5.5 to 18 years. The diagnosis was based on the Porto criteria. Location and clinical manifestation was evaluated according to the Paris classification. Clinical CD activity was assessed with PCDAI and endoscopic activity with SES-CD. In 36 children, control MRE was performed.
The most common endoscopic location of the disease was the colon (41.7%), terminal ileum and colon (24.1%). Inflammation as the main clinical manifestation was dominant (81.5%). In MRE, inflammatory changes were found in 40.8% of children, strictures in 11.1%. The EIA value (activity in MRE) increased along with PCDAI score and SES-CD. MRE performed during follow up, showed transmural healing in 16.7% of patients and improvement in 55.5%.
MRE is an efficient diagnostic tool in proper characterization of disease location in pediatric CD. As positive correlation of the results of MRE with the endoscopic and clinical activity has been found, taking into account good tolerance and non-invasiveness of the procedure it can be recommended to be used in reassessment.
克罗恩病（CD）是一种慢性炎症性疾病，可影响胃肠道的所有部位。磁共振肠造影术（MRE）可检测小肠的病理变化，而这些变化是传统内镜无法检测到的。本研究旨在评估 MRE 在 CD 患者小肠病变的影像学表现、位置和范围及其与临床和内镜活动的相关性。
对 108 例年龄为 5.5 至 18 岁的 CD 患儿进行 MRE 检查。诊断依据为 Porto 标准。根据巴黎分类评估病变位置和临床表现。采用 PCDAI 评估临床 CD 活动度，采用 SES-CD 评估内镜活动度。对 36 例患儿进行了对照 MRE 检查。
疾病最常见的内镜位置是结肠（41.7%）、末端回肠和结肠（24.1%）。以炎症为主要临床表现的占 81.5%。在 MRE 中，40.8%的患儿发现炎症性改变，11.1%发现狭窄。EIA 值（MRE 中的活动度）随着 PCDAI 评分和 SES-CD 的增加而增加。在随访期间进行的 MRE 显示，16.7%的患者出现黏膜愈合，55.5%的患者病情改善。
MRE 是一种有效的诊断工具，可正确描述儿科 CD 的病变位置。鉴于 MRE 结果与内镜和临床活动的相关性较好，且考虑到该方法具有良好的耐受性和非侵入性，可推荐在复查时使用。
