| 陶永丽,李红,许涵,唐文,杨晓春.简化磁共振活动指数评估克罗恩病活动性[J].中国医学影像技术,2022,38(2):220~225 |
| 简化磁共振活动指数评估克罗恩病活动性 |
| Simplified magnetic resonance index of activity for evaluating activity of Crohn disease |
| 投稿时间：2020-07-22 修订日期：2021-09-22 |
| DOI：10.13929/j.issn.1003-3289.2022.02.014 |
| 中文关键词: 克罗恩病 肠 磁共振成像 |
| 英文关键词:Crohn disease intestines magnetic resonance imaging |
| 基金项目: |
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| 中文摘要: |
| 目的 观察简化磁共振活动指数（MaRIAs）评估克罗恩病（CD）活动性的价值。方法 选取79例CD患者，将回结肠分为回肠末段、右半结肠、横结肠、左半结肠及直肠，记录各肠段及总肠段MaRIAs。以CD简化内镜下评分（SES-CD）为金标准，结合粪钙卫蛋白（FC）、红细胞沉降率（ESR）及C反应蛋白（CRP）检测，分析MaRIAs评估CD活动性的效能。结果 总SES-CD示缓解期15例（15/79，18.99%），轻中度活动期29例（29/79，36.71%），重度活动期35例（35/79，44.30%）。随CD活动程度加重，FC、CRP及ESR指标均不同程度增高（P均<0.001）。以MaRIAs≥1分评估活动期CD的特异度为81.37%，敏感度为85.62%，曲线下面积（AUC）为0.90（95%CI 0.87~0.94）；以MaRIAs≥2分评估重度活动期CD的特异度为88.15%，敏感度为85.41%，AUC为0.92（95%CI 0.88~0.96）。MaRIAs与SES-CD评估各肠段CD活动性结果均呈高度相关（r均≥0.6，P均<0.001）；总MaRIAs与总SES-CD显著相关（r=0.80，P<0.001），与ESR、FC及CRP均高度相关（r=0.67、0.65、0.64，P均<0.001）。2名医师评估各肠段壁厚>3 mm及水肿，以及回肠末段、右半结肠和左半结肠存在浆膜面渗出及溃疡的一致性均好（ICC均≥0.75），评估横结肠存在浆膜面渗出及溃疡的一致性较好（ICC=0.74、0.65），而评估直肠的一致性一般（ICC=0.57、0.53）。结论 MaRIAs可准确评估CD活动性。 |
| 英文摘要: |
| Objective To observe the value of simplified magnetic resonance index of activity (MaRIAs) for evaluating the activity of Crohn disease (CD). Methods Totally 79 patients with CD were enrolled. The ileocolon was divided into terminal ileum, right colon, transverse colon, left colon and rectum. MaRIAs evaluation results of each intestinal segment and total intestinal segments were recorded. Taken simple endoscopic score for CD (SES-CD) as the golden standard, combining with faecal calprotectin (FC), erythrocyte sedimentation rate (ESR) and C reactive protein (CRP), the efficacy of MaRIAs for evaluating the activity of CD was observed. Results Total SES-CD showed that 15 cases (15/79, 18.99%) in remission period, 29 in mildly or moderately active period (29/79, 36.71%) and 35 cases (35/79, 44.30%) in severely active period of CD. FC, CRP and ESR rose with the increase of CD activity in various degrees (all P<0.001). The specificity of MaRIAs ≥ 1 for evaluating active period CD was 81.37%, with sensitivity of 85.62% and the area under the curve (AUC) of 0.90 (95%CI 0.87-0.94), while the specificity of MaRIAs ≥ 2 for evaluating severely active period CD was 88.15%, with sensitivity of 85.41% and AUC of 0.92 (95%CI 0.88-0.96). There were high correlations between MaRIAs and SES-CD of each intestinal segments (all r ≥ 0.6, all P<0.001). Total MaRIAs significantly correlated with total SES-CD (r=0.80, P<0.001), and highly correlated with ESR, FC and CRP (r=0.67, 0.65, 0.64, all P<0.001). The consistency of wall thickness > 3 mm and edema of each intestinal segment, fat stranding and ulcer of terminal ileum, right colon and left colon evaluated with 2 doctors were all excellent (all ICC ≥ 0.75). The consistency of fat stranding and ulcer of transverse colon was good (ICC=0.74, 0.65), while of rectum was general (ICC=0.57, 0.53). Conclusion MaRIAs could accurately evaluate the activity of CD. |
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