比较磁共振成像评分系统在克罗恩病活动中的应用：MaRIA、简化 MaRIA 和 Nancy 评分。
Comparison of the magnetic resonance scoring systems for Crohn's disease activity: MaRIA, simplified MaRIA, and Nancy scores.
机构信息
Department of Medical Imaging, National Taiwan University Hospital, No.7, Chung-Shan South Road, Taipei, 100, Taiwan.
Department of Radiology, College of Medicine, National Taiwan University, Taipei, Taiwan.
出版信息
Abdom Radiol (NY). 2023 Jul;48(7):2228-2236. doi: 10.1007/s00261-023-03926-w. Epub 2023 May 2.
PURPOSE
The most widely used score for assessing the activity of Crohn's disease (CD) is the Magnetic Resonance Index of Activity (MaRIA) score, but it is time-consuming. The aim of this study was to compare the diagnostic accuracy of MaRIA score to the other two easily calculated scores.
METHODS
Between January 2011 and May 2021, 67 patients with CD who underwent MRE and ileocolonoscopy within 2 weeks were enrolled. The MRE-based scores including the MaRIA score, simplified MaRIA (sMaRIA) score, and Nancy score for each colonic segment and terminal ileum were calculated and correlated with the ileocolonoscopic findings. The simplified endoscopic score for Crohn's disease (SES-CD) was considered the gold standard.
RESULTS
A total of 343 intestinal segments were included in the analysis, of which 109 (31.8%) showed active inflammation on ileocolonoscopy. The areas under the receiver operating characteristic curve (AUC) of the MaRIA, sMaRIA, and Nancy scores for detecting active disease were 0.752, 0.764, and 0.765, respectively. In the sub-analysis for different indications, the MaRIA and sMaRIA scores showed a higher AUC (0.721 and 0.741) than the Nancy score (0.652) for disease monitoring.
CONCLUSION
The sMARIA and Nancy scores showed comparable diagnostic accuracy to the MaRIA score, and thus could be used as alternatives to the MaRIA score. Furthermore, considering the range of application, especially for disease monitoring, the sMaRIA score may be more suitable for use in clinical practice.
目的
评估克罗恩病（CD）活动的最广泛使用的评分是磁共振活动指数（MaRIA）评分，但它很耗时。本研究的目的是比较 MaRIA 评分与另外两个易于计算的评分的诊断准确性。
方法
2011 年 1 月至 2021 年 5 月，对 67 例在 2 周内接受磁共振肠造影（MRE）和回结肠镜检查的 CD 患者进行了回顾性研究。计算基于 MRE 的评分，包括 MaRIA 评分、简化 MaRIA（sMaRIA）评分和每个结肠节段和末端回肠的 Nancy 评分，并与回结肠镜检查结果相关。简化克罗恩病内镜评分（SES-CD）被认为是金标准。
结果
共纳入 343 个肠段，其中 109 个（31.8%）在回结肠镜下表现为活动性炎症。MaRIA、sMaRIA 和 Nancy 评分检测活动性疾病的受试者工作特征曲线下面积（AUC）分别为 0.752、0.764 和 0.765。在不同适应证的亚分析中，MaRIA 和 sMaRIA 评分对疾病监测的 AUC（0.721 和 0.741）高于 Nancy 评分（0.652）。
结论
sMaRIA 和 Nancy 评分与 MaRIA 评分具有相似的诊断准确性，因此可以替代 MaRIA 评分。此外，考虑到应用范围，特别是疾病监测，sMaRIA 评分可能更适合在临床实践中使用。
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