小儿炎症性肠病的磁共振肠造影小肠运动量化评估--它能反映临床反应吗？

IF 2.1 3区医学 Q2 PEDIATRICS Pediatric Radiology Pub Date : 2024-11-19 DOI:10.1007/s00247-024-06097-y

Riwa Meshaka, Heather E Fitzke, Joy Barber, Kelsey Jones, Stuart A Taylor, Tom A Watson

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引用次数: 0

摘要

背景：使用电影磁共振肠造影术（MRE）对小肠运动进行量化评估已显示出有望成为成人炎症性肠病的生物标志物。在儿科炎症性肠病中，量化的肠蠕动是否与治疗反应相对应尚属未知：材料与方法：这项单一机构的回顾性研究已获得当地伦理批准。所有儿童结果根据临床参考标准，64 名 5-16 岁儿童中有 21 人（33%）有反应，37 人（58%）无反应，6 人（9%）无活动性疾病。两位放射科医生的Δ运动指数在有反应者（+ 16，+ 39）中高于无反应者（-43，-44），每位放射科医生的P = 0.04，P = 0.01。在确定临床反应方面，运动指数比 sMaRIA 更敏感（57% 对 24%），但特异性较低（67% 对 93%）：结论：在儿科炎症性肠病中， cine MRE 的运动指数与临床反应相一致，而且在检测反应方面比 sMaRIA 更灵敏。

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Quantified small bowel motility assessment on magnetic resonance enterography in paediatric inflammatory bowel disease - does it reflect clinical response?

Background: Quantified small bowel motility assessment using cine magnetic resonance enterography (MRE) has shown promise as a biomarker in adult inflammatory bowel disease. Whether quantified motility corresponds to treatment response in paediatric inflammatory bowel disease is unknown.

Objective: To test whether changes in motility reflect response.

Materials and methods: Local ethics approval was granted for this single-institution, retrospective study. All children < 18 years with confirmed inflammatory bowel disease, who had more than one MRE between Jan 2011-Jan 2022, were included. Simplified MaRIA (sMaRIA) and motility index (quantified motility) at all terminal ileum and diseased non-terminal ileum segments were independently assessed by two radiologists each with ≥ 9 years' experience. Change in (Δ) motility index was compared to clinical (gastroenterologist physician's global assessment) and consensus radiological reference standard (response = decrease in sMaRIA of more than or equal to 2 points) in responders versus non-responders using the Mann-Whitney test. Sensitivity and specificity of Δ motility index more than zero were compared to decrease in sMaRIA of 2 or more points for identifying clinical response.

Results: Of 64 children aged 5-16, 21 out of 64 (33%) were responders, 37 out of 64 (58%) were non-responders and 6 out of 64 (9%) had inactive disease according to clinical reference standard. Δ Motility index by both radiologists was higher in responders (+ 16, + 39) than non-responders (-43, -44), P = 0.04, P = 0.01 each radiologist, respectively. Motility index was more sensitive (57% versus 24%), but less specific (67% versus 93%) than sMaRIA in identifying clinical response.

Conclusion: Motility index on cine MRE corresponds to clinical response, and is more sensitive at detecting response compared to sMaRIA in paediatric inflammatory bowel disease.

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来源期刊

Pediatric Radiology 医学-核医学

CiteScore

4.40

自引率

17.40%

发文量

300

审稿时长

3-6 weeks

期刊介绍： Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.