Madsen S M, Thomsen H S, Munkholm P, Dorph S, Schlichting P
Dept. of Medical Gastroenterology, Herlev Hospital, University of Copenhagen, Denmark.
Scand J Gastroenterol. 1998 Nov;33(11):1193-200. doi: 10.1080/00365529850172566.
Our aim was to evaluate low-field magnetic resonance imaging (MRI) in the assessment of disease extension and activity in inflammatory bowel disease.
Nineteen patients with Crohn's disease (CD), 8 with ulcerative colitis (UC), and 5 healthy controls (HC) were examined using MRI (0.1 T) before and after intravenously administered gadodiamide and glucagon. MRI images were evaluated in a blinded fashion and compared with findings at endoscopy, double-contrast barium enema, small-bowel follow-through, and surgery.
Comparisons of diseased with both non-diseased bowel segments and segments from HC showed significant differences for both CD and UC with regard to signal intensity on T2-weighted (SI(T2)) images and post-contrast increment of signal intensity on T1-weighted images (%SI(T1). Agreements with regard to disease extension in CD between MRI and other examinations were 97%, underestimating the extension in two patients. For SI(T2) in CD a cut-off value of 1.0 showed a predictive value of a positive finding (PVpos) = 1.0 and a predictive value of a negative finding (PVneg) = 0.96. For %SI(T1) in CD a cut-off value of 15.0% showed values of PVpos = 0.95 and PVneg = 0.92. Agreements between MRI and conventional methods (disease extension) in UC was 87.5%. Extension was underestimated in two patients and overestimated in two patients as compared with barium enemas. Values of PVpos were 1.0 (SI(T2) >1.0) and 1.0 (%SI(T1) >15.0%), respectively, with corresponding values of PVneg being 0.94 and 0.94.
Low-field MRI seems a promising non-invasive, non-radiating method in the evaluation of inflammatory bowel disease.
我们的目的是评估低场磁共振成像（MRI）在炎性肠病疾病范围及活动度评估中的作用。
19例克罗恩病（CD）患者、8例溃疡性结肠炎（UC）患者及5名健康对照者（HC）在静脉注射钆双胺和胰高血糖素前后接受了0.1T MRI检查。MRI图像由不知情的人员进行评估，并与内镜检查、双重对比钡剂灌肠、小肠造影及手术结果进行比较。
病变肠段与非病变肠段及健康对照者的肠段相比，CD和UC在T2加权像（SI(T2)）信号强度及T1加权像对比剂后信号强度增加值（%SI(T1)）方面均存在显著差异。MRI与其他检查在CD疾病范围方面的一致性为97%，两名患者的病变范围被低估。对于CD中的SI(T2)，截断值为1.0时，阳性预测值（PVpos）=1.0，阴性预测值（PVneg）=0.96。对于CD中的%SI(T1)，截断值为15.0%时，PVpos=0.95，PVneg=0.92。MRI与传统方法（疾病范围）在UC中的一致性为87.5%。与钡剂灌肠相比，两名患者的病变范围被低估，两名患者的病变范围被高估。PVpos值分别为1.0（SI(T2)>1.0）和1.0（%SI(T1)>15.0%），相应的PVneg值分别为0.94和0.94。
低场MRI似乎是一种很有前景的非侵入性、无辐射的炎性肠病评估方法。
