Shoenut J P, Semelka R C, Silverman R, Yaffe C S, Micflikier A B
Department of Medicine, St. Boniface General Hospital, Winnipeg, Manitoba, Canada.
J Clin Gastroenterol. 1993 Jul;17(1):73-8. doi: 10.1097/00004836-199307000-00018.
Magnetic resonance (MR) images were acquired in 28 consecutive inflammatory bowel disease (IBD) patients undergoing medical treatment. The protocol employed included i.v. gadopentatate dimeglumine, pre- and post-contrast breath-hold Fast Low Angle Shot (FLASH), and fat-suppressed spin echo imaging. The percent contrast enhancement (% CE) of the fat-suppressed images was compared with severity of inflammation based on endoscopic and/or surgical findings. The %CE of the contrast-enhanced images was 169% +/- 63 in cases of severe inflammation (n = 16), 97% +/- 38 in moderate inflammation (n = 8), and 49% +/- 26 in mild inflammation (n = 4). Significant correlations were found between the clinicopathologic findings and (a) % CE, r = 0.74 (p = 0.0001); (b) length of affected bowel segment, r = 0.49 (p = 0.007); and (c) bowel wall thickness, r = 0.42 (p = 0.02). In a subsequent comparison, %CE was correlated with length of affected bowel and bowel wall thickness. The best correlation was bowel wall thickness, r = 0.53 (p < 0.004). Good correlation was found between MR findings and pathology/histology findings in the determination of bowel wall thickness, length of diseased bowel, and severity of inflammation in 10 patients who underwent bowel resection. The results of this study show that MR images demonstrate the extent and severity of inflammatory changes in the GI tract, which correlate with endoscopic and histological findings.
对28例接受药物治疗的连续性炎症性肠病（IBD）患者进行了磁共振（MR）成像检查。采用的方案包括静脉注射钆喷酸葡胺、对比剂注射前后屏气快速低角度激发（FLASH）成像以及脂肪抑制自旋回波成像。将脂肪抑制图像的对比增强百分比（%CE）与基于内镜和/或手术结果的炎症严重程度进行比较。在严重炎症（n = 16）病例中，对比增强图像的%CE为169%±63，中度炎症（n = 8）病例中为97%±38，轻度炎症（n = 4）病例中为49%±26。发现临床病理结果与以下各项之间存在显著相关性：（a）%CE，r = 0.74（p = 0.0001）；（b）受累肠段长度，r = 0.49（p = 0.007）；（c）肠壁厚度，r = 0.42（p = 0.02）。在随后的比较中，%CE与受累肠段长度和肠壁厚度相关。最佳相关性为肠壁厚度，r = 0.53（p < 0.004）。在10例接受肠切除术的患者中，发现MR结果与病理/组织学结果在肠壁厚度、病变肠段长度和炎症严重程度的判定方面具有良好相关性。本研究结果表明，MR图像可显示胃肠道炎症变化的范围和严重程度，且与内镜和组织学结果相关。
