Jensen Laura J, Loch Florian N, Kamphues Carsten, Shahryari Mehrgan, Marticorena Garcia Stephan R, Siegmund Britta, Weidinger Carl, Kühl Anja A, Hamm Bernd, Braun Jürgen, Sack Ingolf, Asbach Patrick, Reiter Rolf
Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Department of Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Quant Imaging Med Surg. 2023 Aug 1;13(8):4792-4805. doi: 10.21037/qims-23-41. Epub 2023 Jun 28.
Although there is growing evidence that functional involvement and structural changes of mesenteric adipose tissue (MAT) influence the course of Crohn's disease (CD), its viscoelastic properties remain elusive. Therefore, we aimed to investigate the viscoelastic properties of MAT in CD using magnetic resonance elastography (MRE), providing reference values for CD diagnosis.
In this prospective proof-of-concept study, 31 subjects (CD: n=11; healthy controls: n=20) were consecutively enrolled in a specialized care center for inflammatory bowel diseases (tertiary/quaternary care). Inclusion criteria for the CD patients were a clinically and endoscopically established diagnosis of CD based on the clinical record, absence of other concurrent bowel diseases, scheduled surgery for the following day, and age of at least 18 years. Diagnoses were confirmed by histological analysis of the resected bowel the day after MRE. Subjects were investigated using MRE at 1.5-T with frequencies of 40-70 Hz. To retrieve shear wave speed (SWS), volumes of interest (VOIs) in MAT were drawn adjacent to CD lesions (MAT) and on the opposite side without adjacent bowel lesions in patients (MAT) and controls (MAT). The presented study is not registered in the clinical trial platform.
A statistically significant decrease in mean SWS of 7% was found for MAT MAT (0.76±0.05 0.82±0.04 m/s, P=0.012), whereas there was a nonsignificant trend with an 8% increase for MAT MAT (0.82±0.07 0.76±0.05 m/s, P=0.098) and no difference for MAT MAT. Preliminary area under the receiver operating characteristic curve (AUC) analysis showed diagnostic accuracy in detecting CD to be excellent for SWS of MAT [AUC =0.82; 95% confidence interval (CI): 0.64-0.96] but poor for SWS of MAT (AUC =0.52; 95% CI: 0.34-0.73).
This study demonstrates the feasibility of MRE of MAT and presents preliminary reference values for CD patients and healthy controls. Our results motivate further studies for the biophysical characterization of MAT in inflammatory bowel disease.
尽管越来越多的证据表明肠系膜脂肪组织（MAT）的功能参与和结构变化会影响克罗恩病（CD）的病程，但其粘弹性特性仍不清楚。因此，我们旨在使用磁共振弹性成像（MRE）研究CD患者MAT的粘弹性特性，为CD诊断提供参考值。
在这项前瞻性概念验证研究中，31名受试者（CD患者：n = 11；健康对照：n = 20）连续入组一家专门的炎症性肠病护理中心（三级/四级护理）。CD患者的纳入标准为基于临床记录在临床和内镜下确诊为CD、无其他并发肠道疾病、次日计划进行手术以及年龄至少18岁。诊断通过MRE后一天切除肠段的组织学分析得以证实。受试者使用1.5-T的MRE进行检查，频率为40 - 70 Hz。为获取剪切波速度（SWS），在患者（MAT）和对照（MAT）中，在靠近CD病变处（MAT）以及在无相邻肠道病变的对侧绘制MAT的感兴趣区（VOI）。本研究未在临床试验平台注册。
发现MAT的平均SWS有统计学意义地降低了7%（0.76±0.05对0.82±0.04 m/s，P = 0.012），而MAT有增加8%的非显著趋势（0.82±0.07对0.76±0.05 m/s，P = 0.098），MAT则无差异。初步的受试者工作特征曲线（AUC）分析显示，MAT的SWS检测CD的诊断准确性极佳[AUC = 0.82；95%置信区间（CI）：0.64 - 0.96]，而MAT的SWS诊断准确性较差（AUC = 0.52；95% CI：0.34 - 0.73）。
本研究证明了MAT的MRE的可行性，并给出了CD患者和健康对照的初步参考值。我们的结果促使对炎症性肠病中MAT的生物物理特性进行进一步研究。
