BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.
Top Magn Reson Imaging. 2021 Feb 1;30(1):31-41. doi: 10.1097/RMR.0000000000000264.
In this review article, we present the latest developments in quantitative imaging biomarkers based on magnetic resonance imaging (MRI), applied to the diagnosis, assessment of response to therapy, and assessment of prognosis of Crohn disease. We also discuss the biomarkers' limitations and future prospects. We performed a literature search of clinical and translational research in Crohn disease using diffusion-weighted MRI (DWI-MRI), dynamic contrast-enhanced MRI (DCE-MRI), motility MRI, and magnetization transfer MRI, as well as emerging topics such as T1 mapping, radiomics, and artificial intelligence. These techniques are integrated in and combined with qualitative image assessment of magnetic resonance enterography (MRE) examinations. Quantitative MRI biomarkers add value to MRE qualitative assessment, achieving substantial diagnostic performance (area under receiver-operating curve = 0.8-0.95). The studies reviewed show that the combination of multiple MRI sequences in a multiparametric quantitative fashion provides rich information that may help for better diagnosis, assessment of severity, prognostication, and assessment of response to biological treatment. However, the addition of quantitative sequences to MRE examinations has potential drawbacks, including increased scan time and the need for further validation before being used in therapeutic drug trials as well as the clinic.
在这篇综述文章中，我们介绍了基于磁共振成像（MRI）的定量成像生物标志物的最新进展，这些生物标志物应用于克罗恩病的诊断、治疗反应评估和预后评估。我们还讨论了这些生物标志物的局限性和未来前景。我们使用扩散加权 MRI（DWI-MRI）、动态对比增强 MRI（DCE-MRI）、动力 MRI 和磁化传递 MRI 以及新兴主题，如 T1 映射、放射组学和人工智能，对克罗恩病的临床和转化研究进行了文献检索。这些技术与磁共振肠造影（MRE）检查的定性图像评估相结合并进行了组合。定量 MRI 生物标志物为 MRE 定性评估增加了价值，实现了出色的诊断性能（接受者操作特征曲线下面积=0.8-0.95）。综述中的研究表明，以多参数定量方式结合多种 MRI 序列可提供丰富的信息，有助于更好地诊断、评估严重程度、预测预后以及评估对生物治疗的反应。然而，将定量序列添加到 MRE 检查中可能存在潜在的缺点，包括扫描时间延长，以及在将其用于治疗药物试验和临床之前需要进一步验证。
