表明溃疡性结肠炎结肠永久性损伤的 MRI 特征:一项探索性研究。

Jordi Rimola, Jesús Castro-Poceiro, Víctor Sapena, Marta Aduna, Juan Arevalo, Isabel Vera, Miguel Ángel Pastrana, Marta Gallego, Maria Carme Masamunt, Agnès Fernández-Clotet, Ingrid Ordás, Elena Ricart, Julian Panés
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引用次数: 0

摘要

背景和目的:目前尚不确定溃疡性结肠炎是否会导致横断面图像上的累积性肠道损伤。我们旨在利用磁共振成像描述溃疡性结肠炎患者肠道损伤的特征,并确定其与病程的关系以及对患者生活质量的影响:在这项前瞻性研究中,内镜缓解期溃疡性结肠炎患者在未清洗肠道的情况下接受了磁共振成像检查,并填写了生活质量调查问卷。对受试者的磁共振结果进行分析时,考虑了正常值和无炎症性肠病病史的对照组(40 人)以及无结肠受累病史的克罗恩病患者(12 人)的阈值。根据病程(14 年)对患有 UC 的受试者进行分层:我们分析了 41 名溃疡性结肠炎患者(20 名女性;38 人(92.7%)的梅奥内镜子评分为 0,3 人(7.3%)的梅奥内镜子评分为 1)。将记录为受溃疡性结肠炎影响的结肠段与对照组的磁共振结果进行逐段配对比较,结果显示,溃疡性结肠炎患者所有结肠段的横截面积(p≤0.0034)和周长(p≤0.0005)均缩小,结肠壁厚度增加(p=0.026)。有 22 名受试者(53.7%)出现结肠损伤,即结肠壁厚度≥3 毫米。结肠损伤与病程或生活质量无关:结论:在没有炎症的情况下,结肠形态异常在溃疡性结肠炎患者中非常普遍。结肠结构损伤与病程和生活质量无关。
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Magnetic Resonance Imaging Features Indicative of Permanent Colon Damage in Ulcerative Colitis: An Exploratory Study.

Background and aims: It is uncertain whether ulcerative colitis leads to accumulated bowel damage on cross-sectional image. We aimed to characterise bowel damage in patients with ulcerative colitis using magnetic resonance imaging [MRI], and to determine its relation with duration of disease and the impact on patients' quality of life.

Methods: In this prospective study, patients with ulcerative colitis [UC] in endoscopic remission underwent MRI without bowel cleansing, and completed quality-of-life questionnaires. Participants' magnetic resonance findings were analysed considering normal values and thresholds determined in controls with no history of inflammatory bowel disease [n=40], and in patients with Crohn's disease with no history of colonic involvement [n = 12]. Subjects with UC were stratified according to disease duration [< 7 years vs 7‒14 years vs > 14 years].

Results: We analysed 41 subjects with ulcerative colitis [20 women; Mayo endoscopic subscore 0 in 38 [92.7%] and 1 in three [7.3%]]. Paired segment-by-segment comparison of magnetic resonance findings in colonic segments documented as being affected by ulcerative colitis versus controls showed that patients with ulcerative colitis had decreased cross-sectional area [p ≤ 0.0034] and perimeter [p ≤ 0.0005] and increased wall thickness [p = 0.026] in all segments. Colon damage, defined as wall thickness ≥ 3 mm, was seen in 22 [53.7%] patients. Colon damage was not associated with disease duration or quality of life.

Conclusions: Morphological abnormalities in the colon were highly prevalent in patients with ulcerative colitis in the absence of inflammation. Structural bowel damage was not associated with disease duration or quality of life.

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