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磁共振弥散加权成像在评估Crohn’s肛瘘炎症活动度中的价值 被引量:17

Value of magnetic resonance diffusion-weighted imaging for evaluating the inflammatory activity of perianal Crohn's fistula
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摘要 目的:探讨磁共振弥散加权成像(magnetic resonance dif fusion-weighted imaging,MR-DWI)在评估Crohn’s肛周瘘管炎症活动度中的价值。方法:回顾性分析55例经手术和/或肠镜证实的Crohn’s病伴发肛瘘患者的临床资料,所有患者在治疗前及治疗32周后分别行MRI检查。根据治疗结果将患者分为有效组(34例)和无效组(21例),分析两组患者治疗前后的MRI图像,测量表观弥散系数(apparent dif fusion coef f icient,ADC),采用配对t检验分析两组治疗前后ADC值的变化;同时以MRI评分作为参照,分析两组患者ADC值与MRI评分之间的相关性。结果:有效组治疗后ADC值高于治疗前(P<0.05),无效组治疗前后ADC值比较差异无明显统计学意义(P>0.05)。有效组治疗前后ADC值与MRI评分呈强负相关(r=–0.672, P<0.01),有效组+无效组治疗前后ADC值与MRI评分亦呈强负相关(r=–0.638,P<0.01)。结论:肛周瘘管ADC值变化与病灶炎症活动度相关,MR-DWI及ADC值测量可以较准确地判断Crohn’s肛瘘的炎症活动度。 Objective: To explore the value of magnetic resonance diffusion-weighted imaging (MR-DWI) for evaluating inflammatory activity of perianal Crohn’s fistula. Methods: A total of 55 patients, who were diagnosed as perianal Crohn’s fistula by surgery and/ or endoscopy, were assessed retrospectively. All patients, underwent pelvic magnetic resonance imaging (MRI) before and 32 weeks after the treatment, were divided into 2 groups according to their response to treatment: an effective group (34 cases) and an ineff ective group (21 cases). The MRI images of patients in the 2 groups were analyzed. The changes of apparent diffusion coefficient (ADC) values before and after treatment in the 2 groups were measured and compared by a paired t-test. An MRI-based score of perianal Crohn’s disease severity was calculated as a reference standard, and the correlation between the ADC value and the MRI-based score was analyzed by using a Pearson correlation coefficient method. Results: In the effective group, the ADC values after therapy were significantly greater than those before therapy (P<0.05), but in the ineffective group, there was no significant difference in the ADC value between after and before therapy (P>0.05). There was a strong negative correlation between the ADC values (after and before therapy) and the MRI-based scores in all the patients [in the effective group alone (r=–0.672, P<0.01) or in the effective group + the ineffective group (r=–0.638, P<0.01)]. Conclusion: Changes in the ADC values of perianal fistula are related to the fistula activity. MRDWI and ADC value can accurately evaluate the inflammatory activity of perianal Crohn’s fistula.
作者 王绍娟 唐晓雯 王中秋 王浩 WANG Shaojuan;TANG Xiaowen;WANG Zhongqiu;WANG Hao(Department of Radiology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210009;Department of Radiology,Jiangsu Cancer Hospital,Nanjing 210029,China)
出处 《中南大学学报(医学版)》 CAS CSCD 北大核心 2019年第2期173-179,共7页 Journal of Central South University :Medical Science
关键词 肛瘘 Crohn’s病 磁共振弥散加权成像 表观弥散系数 炎症活动度 perianal fistula Crohn’s disease magnetic resonance diffusion-weighted imaging apparent diffusion coefficient inflammatory activity
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