Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden.
Department of Translational Medicine, Diagnostic Radiology, Skåne University Hospital, Lund University, Malmö, Sweden.
Neurogastroenterol Motil. 2020 Oct;32(10):e13909. doi: 10.1111/nmo.13909. Epub 2020 May 29.
Quantified terminal ileal motility during magnetic resonance enterography (MRE) has been suggested to be used as a biomarker of Crohn's disease (CD). The aim of the present study was to evaluate this method in clinical practice.
Healthy volunteers and all consecutive patients referred to MRE during a 2-year period were asked to participate and complete the Irritable Bowel Syndrome-Symptom Severity Scale (IBS-SSS) to assess gastrointestinal symptoms. Medical records were scrutinized, and motility indices (MIs) were calculated from MR images.
Twenty-two healthy controls and 134 examinations with CD were included (inclusion rate: 76.3%). Patients with CD had increased mural thickness of the terminal ileum, increased fecal calprotectin, and more symptoms than controls. Patients with active CD had increased mural thickness of ileum and terminal ileum, higher MR activity indices, and signs of inflammation in laboratory analyses, but similar symptoms, compared with inactive disease. After exclusion of sole colon disease (n = 13), MI inversely correlated with mural thickness in terminal ileum, and MI was lower in active disease versus controls in ileum (P = .019) and terminal ileum (P = .005), and versus inactive disease in terminal ileum (P = .044). The area under the curve of MI in terminal ileum was 0.736 for active CD against healthy controls (P = .002) and 0.682 for active against inactive CD (P = .001). MIs were similar in controls and inactive CD.
MI reflects inflammatory activity in the intestine. Alterations in MI did not explain symptomatology in inactive CD, without measurable inflammatory parameters in morphology or laboratory analyses.
磁共振肠造影（MRE）期间量化的末端回肠动力已被提议用作克罗恩病（CD）的生物标志物。本研究的目的是评估该方法在临床实践中的应用。
健康志愿者和在 2 年内接受 MRE 检查的所有连续患者都被要求参加并完成肠易激综合征症状严重程度量表（IBS-SSS）以评估胃肠道症状。仔细检查病历，并从 MR 图像计算运动指数（MI）。
纳入了 22 名健康对照者和 134 例 CD 患者（纳入率：76.3%）。CD 患者的末端回肠壁厚度增加，粪便钙卫蛋白增加，症状比对照组多。与活动性疾病相比，活动性 CD 患者的回肠和末端回肠壁厚度增加，MR 活动指数更高，实验室分析中有炎症迹象，但症状相似。排除单纯结肠疾病（n=13）后，末端回肠的 MI 与壁厚度呈负相关，与对照组相比，活动性疾病的 MI 在回肠（P=0.019）和末端回肠（P=0.005）中较低，与不活动疾病相比在末端回肠中较低（P=0.044）。末端回肠 MI 的曲线下面积为 0.736，用于活动性 CD 与健康对照组（P=0.002），0.682 用于活动性 CD 与不活动 CD（P=0.001）。对照者和不活动 CD 之间的 MI 相似。
MI 反映了肠道的炎症活动。在不活动的 CD 中，MI 的改变并不能解释症状，因为在形态学或实验室分析中没有可测量的炎症参数。
