Cicero Giuseppe, Mondello Stefania, Wichmann Julian L, Albrecht Moritz H, Vogl Thomas J, Cavallaro Marco, Frosina Luciano, D'Angelo Tommaso, Mazziotti Silvio
Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria, Messina, Italy.
Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Germany, Theodor-Stern-Kai 7, Frankfurt am Main, Germany.
J Clin Imaging Sci. 2020 May 2;10:25. doi: 10.25259/JCIS_18_2020. eCollection 2020.
Magnetic resonance enterography has achieved an increasingly importance in the evaluation of patients with Crohn's disease, although it is limited by high costs and prolonged scanning times. The aim of our work was to design a "fast" abbreviated MRE protocol and to compare it with the standard one.
A single-center retrospective study was performed on 73 patients with Crohn's disease who underwent MRE with standard protocol over a 7-month period. The images of the standard protocol were separated from those included in the proposed abbreviated one and independently evaluated by two radiologists with different years of experience in MRE imaging. Statistical analysis was performed with the Cohen kappa (κ) value, used to assess the agreement in case of categorical variables, the Lin's concordance correlation coefficient and Bland-Altman plot, in assessing the degree of agreement between numerical measurements, while the non- parametric Mann-Whitney U-test was used in comparing the evaluation times of the two protocols.
The intraobserver evaluation showed a perfect agreement between the two protocols for presence, number and extension of lesions, abdominal complications, and excellent/perfect in identification of active inflammation.The interobserver reproducibility was excellent for overall presence and number of lesions, for the presence and number of lesions in any abdominal quadrant, inflammation, intestinal and extraintestinal complications, and lesions extension.
The proposed protocol achieves comparable performance with standard MRE. Furthermore, it would carry potential benefits in terms of patient's comfort, time, and health-care costs savings.
尽管磁共振小肠造影因成本高和扫描时间长而受到限制，但在克罗恩病患者的评估中已变得越来越重要。我们研究的目的是设计一种“快速”简化磁共振小肠造影方案，并将其与标准方案进行比较。
对73例克罗恩病患者进行了一项单中心回顾性研究，这些患者在7个月内接受了标准方案的磁共振小肠造影检查。将标准方案的图像与拟议简化方案中的图像分开，由两位在磁共振小肠造影成像方面经验不同的放射科医生独立评估。使用科恩kappa（κ）值进行统计分析，用于评估分类变量情况下的一致性；使用林氏一致性相关系数和布兰德-奥特曼图，用于评估数值测量之间的一致程度，同时使用非参数曼-惠特尼U检验比较两种方案的评估时间。
观察者内评估显示，两种方案在病变的存在、数量和范围、腹部并发症以及识别活动性炎症方面表现完美/出色。观察者间的可重复性在病变的总体存在和数量、任何腹部象限的病变存在和数量、炎症、肠道和肠外并发症以及病变范围方面都非常出色。
所提出的方案与标准磁共振小肠造影具有可比的性能。此外，在患者舒适度、时间和节省医疗成本方面可能具有潜在益处。
