利用CDMI和MEGS指数评估克罗恩病炎症活动性的磁共振小肠结肠镜检查

I. Zarodnyuk, R. Eligulashvili, V. Veselov, V. A. Mikhalchenko, B. Nanaeva, A. Vardanyan, E. Peda
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摘要

目的:探讨应用炎症指数(CDMI、MEGS)评估结肠和小肠炎症过程活性的磁共振小肠结肠镜检查对克罗恩病的诊断价值。患者和方法:该研究包括42例克罗恩病患者(年龄从19岁到47岁)。所有患者均行磁共振小肠结肠镜(MRE)静脉造影和弥散加权成像。根据MRE结果,测定小肠和大肠炎症活动的MR指标- CDMI和MEGS。MR炎症活动指数CDMI和MEGS与内镜下炎症活动指数SES-CD进行比较。结果:MR炎症活动指数CDMI的诊断效率无统计学意义(p>0.05)。MR炎症活动指数MEGS的诊断效率有统计学意义(p<0.0001)。从图上可以看出,磁共振炎症活动指数MEGS对确定小肠和大肠炎症过程的真实活动具有很高的预测能力。MEGS炎症指数的定量值与内镜下炎症指数(SES-CD)呈直接强相关(r=0.843, p<0.0001)。结论:应用MEGS活性指数进行磁共振小肠结肠镜检查对克罗恩病小肠和大肠炎症过程的活性评估具有较高的诊断效率。MR炎症活动指数CDMI的诊断效果无统计学意义。这项研究的结果应该被认为是初步的,需要在更大的患者样本中进一步研究这些炎症活性指标的可能性。
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Magnetic resonance enterocolonography for assessing inflammation activity in Crohn’s disease using the CDMI and MEGS indices
AIM: to determine the diagnostic efficiency of magnetic resonance enterocolonography using inflammation indices (CDMI, MEGS) in assessing activity of the inflammatory process in the colon and small intestine in Crohn's disease.PATIENTS AND METHODS: the study included 42 patients with Crohn's disease (age ranged from 19 to 47 years). All patients underwent magnetic resonance enterocolonography (MRE) with intravenous contrast and diffusion-weighted images. According to the results of MRE, were determined MR indices of inflammation activity in the small and large intestine - CDMI and MEGS. The MR inflammatory activity indices CDMI and MEGS were compared with the endoscopic inflammatory activity index SES-CD.RESULTS: the MR inflammation activity index CDMI did not show a statistically significant diagnostic efficiency (p>0.05). The MR inflammation activity index MEGS showed a statistically significant diagnostic efficiency (p<0.0001). According to the nomogram, the MR inflammation activity index MEGS demonstrated a high predictive ability to determine the true activity of the inflammatory process in the small and large intestine. Correlation demonstrated direct strong relationship between the quantitative values of the MEGS inflammation indices and the endoscopic inflammation index (SES-CD) (r=0.843, p<0.0001).CONCLUSION: magnetic resonance enterocolonography using the MEGS activity index has a high diagnostic efficiency in assessing the activity of the inflammatory process in the small and large intestine in Crohn's disease. The MR inflammation activity index CDMI did not show statistically significant diagnostic efficacy. The results of the study should be considered preliminary and require further study of the possibilities of these indices of inflammation activity in a larger sample of patients.
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