Department of Radiology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Rd, Fuzhou, 350000, Fujian, China.
MR, Siemens Healthcare, Shanghai, China.
Abdom Radiol (NY). 2020 Nov;45(11):3653-3661. doi: 10.1007/s00261-020-02590-8.
The aim of this study is to evaluate the ability of magnetic resonance enterography global score (MEGS) to diagnose the activity of pediatric Crohn's disease (CD) and its correlation with endoscopic activity score.
70 pediatric CD patients (between the ages of 6 and 17) were enrolled who underwent ileocolonoscopy and magnetic resonance enterography (MRE) within 7 days. The simplified endoscopic activity score for Crohn's disease (SES-CD) and MEGS were acquired in the terminal ileum. Sensitivity and specificity of MEGS for detection disease activity against SES-CD was compared using the McNemar test. The correlation between MEGS and SES-CD was assessed by Spearman's rank estimation. The diagnostic accuracy of MEGS for active disease defined by SES-CD was calculated. Receiver operating characteristic curves (ROC) were constructed.
Fifty-two pediatric CD patients (median age, 12 years old; 28 girls, 24 boys) were included. The incidence of upper gastrointestinal (GI) tract (23%) involvement and perianal lesions (42%) is high in pediatric Crohn's patients, and most of them suffer from internal hemorrhoids (86.5%). MEGS showed strong correlation to SES-CD (r = 0.70, P < 0.001). With endoscopic as the standard of reference, the MEGS had a high accuracy for the detection of inflammation (area under the ROC curve (AUC) of 0.89, sensitivity 0.95 and specificity 0.82) and for disease activity (AUC of 0.81, sensitivity 0.88 and specificity 0.75) in the terminal ileum.
Pediatric Crohn's disease is unique. Our study has shown a good correlation between MEGS and endoscopy activity score with equal diagnostic efficacy. MEGS is a promising method to assess disease activity and perhaps be a valuable tool in following therapeutic changes.
本研究旨在评估磁共振肠造影全球评分（MEGS）诊断儿童克罗恩病（CD）活动的能力及其与内镜活动评分的相关性。
本研究纳入了 70 名年龄在 6 至 17 岁之间的儿科 CD 患者，他们在 7 天内接受了回结肠镜检查和磁共振肠造影（MRE）。在回肠末端获得简化的克罗恩病内镜活动评分（SES-CD）和 MEGS。使用 McNemar 检验比较 MEGS 检测疾病活动对 SES-CD 的敏感性和特异性。采用 Spearman 秩估计评估 MEGS 与 SES-CD 之间的相关性。计算 MEGS 对 SES-CD 定义的活动疾病的诊断准确性。构建受试者工作特征曲线（ROC）。
本研究纳入了 52 名儿科 CD 患者（中位年龄 12 岁；28 名女性，24 名男性）。儿科 CD 患者上消化道（GI）受累（23%）和肛周病变（42%）的发生率较高，其中大多数患有内痔（86.5%）。MEGS 与 SES-CD 呈强相关性（r=0.70，P<0.001）。以内镜为参考标准，MEGS 对回肠末端炎症（ROC 曲线下面积（AUC）为 0.89，敏感性为 0.95，特异性为 0.82）和疾病活动（AUC 为 0.81，敏感性为 0.88，特异性为 0.75）的检测具有较高的准确性。
儿科 CD 具有独特的特征。我们的研究表明，MEGS 与内镜活动评分之间具有良好的相关性，且具有同等的诊断效能。MEGS 是一种评估疾病活动的有前途的方法，也许是监测治疗变化的有价值的工具。
