Maccioni Francesca, Busato Ludovica, Valenti Alessandra, Cardaccio Sara, Longhi Alessandro, Catalano Carlo
Department of Radiological Sciences, Pathology and Oncology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy.
Diagnostics (Basel). 2023 Jul 19;13(14):2410. doi: 10.3390/diagnostics13142410.
This review focuses on the role of magnetic resonance imaging (MRI) in the evaluation of the gastrointestinal tract (GI MRI), analyzing the major technical advances achieved in this field, such as diffusion-weighted imaging, molecular imaging, motility studies, and artificial intelligence. Today, MRI performed with the more advanced imaging techniques allows accurate assessment of many bowel diseases, particularly inflammatory bowel disease and rectal cancer; in most of these diseases, MRI is invaluable for diagnosis, staging, and disease monitoring under treatment. Several MRI parameters are currently considered activity biomarkers for inflammation and neoplastic disease. Furthermore, in younger patients with acute or chronic GI disease, MRI can be safely used for short-term follow-up studies in many critical clinical situations because it is radiation-free. MRI assessment of functional gastro-esophageal and small bowel disorders is still in its infancy but very promising, while it is well established and widely used for dynamic assessment of anorectal and pelvic floor dysfunction; MRI motility biomarkers have also been described. There are still some limitations to GI MRI related to high cost and limited accessibility. However, technical advances are expected, such as faster sequences, more specific intestinal contrast agents, AI analysis of MRI data, and possibly increased accessibility to GI MRI studies. Clinical interest in the evaluation of bowel disease using MRI is already very high, but is expected to increase significantly in the coming years.
本综述聚焦于磁共振成像（MRI）在胃肠道评估中的作用（胃肠MRI），分析该领域取得的主要技术进展，如扩散加权成像、分子成像、动力研究和人工智能。如今，采用更先进成像技术进行的MRI能够准确评估多种肠道疾病，尤其是炎症性肠病和直肠癌；在大多数此类疾病中，MRI在诊断、分期及治疗过程中的疾病监测方面具有极高价值。目前，多种MRI参数被视为炎症和肿瘤性疾病的活性生物标志物。此外，对于患有急性或慢性胃肠疾病的年轻患者，由于MRI无辐射，在许多关键临床情况下可安全用于短期随访研究。MRI对功能性胃食管和小肠疾病的评估仍处于起步阶段，但前景广阔，而其在肛门直肠和盆底功能障碍的动态评估方面已成熟且广泛应用；MRI动力生物标志物也已被描述。胃肠MRI仍存在一些局限性，如成本高和可及性有限。然而，预计会有技术进步，如更快的序列、更具特异性的肠道造影剂、MRI数据的人工智能分析，以及胃肠MRI研究的可及性可能提高。目前临床对使用MRI评估肠道疾病的兴趣已然很高，但预计在未来几年还会大幅增加。
