磁共振弥散加权成像对克罗恩病继发肠道狭窄的性质判定

发布时间：2018-06-25 01:29

本文选题：克罗恩病 + 炎性肠道狭窄　；参考：《医学研究生学报》2015年05期

【摘要】：目的肠道狭窄是克罗恩病的并发症之一,不同原因需采取不同的治疗方案。文中旨在运用磁共振弥散加权成像(diffusion-weighted imaging,DWI)对克罗恩病狭窄肠段进行研究,探讨该方法对于克罗恩病继发肠道狭窄性质的判定价值。方法收集2014年1月至同年6月,经南京医科大学第二附属医院肠镜检查、并病理确诊的31例克罗恩患者,男18例、女13例,年龄21~71岁,平均(38.90±13.65)岁。所有患者均接受3.0 T磁共振常规序列和弥散加权序列扫描。根据患者常规磁共振平扫的表现判断狭窄最严重的肠段,行弥散加权序列检查,并测量该病变段肠壁的表面扩散系数。所有患者在24 h内接受结肠镜检查。根据肠镜表现和病理结果将31例患者分为炎性狭窄组(n=21)和纤维性狭窄组(n=10)。观察组间表面扩散系数差异并计算截断点。结果炎性狭窄组病变段肠壁的表面扩散系数值为(1.01~1.83)×103mm2/s,平均(1.40±0.23)×103mm2/s;纤维性狭窄组为(0.53~1.03)×103mm2/s,平均(0.80±0.16)×103mm2/s。组间比较差异有统计学意义(P0.05)。受试者工作特征曲线曲线下面积为0.981(95%CI 0.943~1.000),将1.11×103mm2/s作为截断点,对炎性狭窄判断的敏感性和特异性分别为90.5%和100%。结论由于不同病理成份对水分子运动的限制程度不一,故通过测量表面扩散系数可以得到定量参数,有助于DWI对克罗恩病继发肠道狭窄性质的鉴别诊断。
[Abstract]:Objective intestinal stenosis is one of the complications of Crohn's disease. Different treatments are required for different reasons. The purpose of this study is to study the narrow intestinal segment of Crohn's disease by diffusion-weighted imaging (DWI), and to explore the value of this method to determine the nature of secondary intestinal stenosis secondary to Crohn's disease. Methods 20 From January 14 to June of the same year, 31 Krohn patients, 18 males and 13 females, aged 21~71 years old, with an average age of (38.90 + 13.65) years old, were confirmed by the Second Affiliated Hospital of Nanjing Medical University in the Second Affiliated Hospital. All patients received 3 T MRI routine sequence and diffusion weighted sequence scan. The most severe intestinal segment was examined by diffusion weighted sequence, and the surface diffusion coefficient of the intestinal wall was measured. All patients received colonoscopy within 24 h. According to the enteroscopy and pathological results, 31 patients were divided into inflammatory stenosis group (n=21) and fibrous stenosis group (n=10). The difference of surface diffusion coefficient between the groups was observed and the truncation point was calculated. Results the surface diffusion of the intestinal wall of the inflammatory stenosis group was (1.01~1.83) x 103mm2/s, averaging (1.40 + 0.23) x 103mm2/s, and the fibrous stenosis group was (0.53~1.03) x 103mm2/s, and the average (0.80 + 0.16) x 103mm2/s. group was statistically significant (P0.05). The area under the curve of the subjects' working curve was 0.981 (95%CI 0.943~1.000). By using 1.11 x 103mm2/s as a truncation point, the sensitivity and specificity of judging inflammatory stenosis were 90.5% and 100%., respectively, as a result of different restrictions on the movement of water molecules due to different pathological components. Therefore, the quantitative parameters could be obtained by measuring the surface diffusion coefficient, which was helpful for the differential diagnosis of the secondary intestinal stenosis secondary to Crohn's disease.
【作者单位】：南京医科大学第二附属医院放射科;南京医科大学第二附属医院消化科;
【基金】：江苏省省级条件建设与民生科技专项资金(BL2014097)
【分类号】：R574.62;R445.2

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