Evaluation of treatment response in active Crohn's disease by low-field magnetic resonance imaging
Evaluation of treatment response in active Crohn's disease by low-field magnetic resonance imaging
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DOI：
10.1007/s002619900487
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发表时间：
1999-05-01
影响因子：
--
通讯作者：
Munkholm, P
中科院分区：
文献类型：
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作者：
Madsen, SM;Thomsen, HS;Munkholm, P
背景资料：为了评估低场磁共振成像（MRI）在检测治疗反应，在活动性克罗恩病在治疗过程中与全身steroids.Methods：8例活动性克罗恩病进行了检查之前和治疗过程中与全身类固醇（1毫克/公斤/天），使用低场MRI（0.1 T）在横向和冠状面之前和之后静脉注射团钆双胺。以同样的方式检查了5名健康人。MRI图像的评价不包括诊断、治疗或内窥镜检查、常规X线摄影和手术结果。结果：病变肠段与非病变肠段在T2-WI上的信号强度（SIT 2）和增强后T1 WI上的信号强度增量（%SIT1）均有显著性差异0001; %SIT2：p = 0.0009）和来自对照组的片段（SIT 2：p < 0.00005; %SIT1：p < 0.00005）。在评价的56个肠段中的53个（95%）中，发现MRI、常规X线摄影、内窥镜检查和/或手术关于疾病扩展的结果一致。2例患者的延长被低估。对照组受试者的所有肠段在MRI上被评估为正常。SIT 1（p < 0.0025）和%SIT1（p < 0.025）与内镜活动分级之间存在显著相关性。在治疗过程中，SIT 2（p < 0.00005），%SIT1（p = 0.002），和肠壁厚度（I，= 0.03）的显着递减被发现。结论：低场MRI似乎是一个有前途的非侵入性方法，在评价反应的疾病扩展和活动在克罗恩病在治疗过程中与全身类固醇。
Background: To evaluate low-field magnetic resonance imaging (MRI) in detecting therapeutic response in active Crohn's disease during treatment with systemic steroids.Methods: Eight patients with active Crohn's disease were examined before and during treatment with systemic steroids (1 mg/kg/day) using low-field MRI (0.1 T) in transverse and coronal planes before and after an intravenously administered bolus of gadodiamide. Five healthy persons were once examined in the same way. MRI images were evaluated without knowledge of diagnosis, treatment, or findings of endoscopy, conventional radiography, and surgery. Proximal and mid small bowel, terminal ileum, right-sided colon, transverse colon, and left-sided colon were evaluated separately.Results: Statistically significant differences were shown for both signal intensity on T2- (SIT2) and increment in signal intensity on T1-weighted images after contrast (%SIT1) when comparing diseased bowel segments with both nondiseased bowel segments (SIT2: p = 0.0001; %SIT2: p = 0.0009) and segments from the control group (SIT2: p < 0.00005; %SIT1: p < 0.00005). In 53 of 56 bowel segments evaluated (95%), agreement was found between findings by MRI, conventional radiography, endoscopy and/or surgery regarding disease extension. Extension was underestimated in two patients. All bowel segments in the control subjects were evaluated to be normal on MRI. Significant correlation was found between both SIT1 (p < 0.0025) and %SIT1 (p < 0.025) versus endoscopic activity gradings. During treatment, significant decrements of both SIT2 (p < 0.00005), %SIT1 (p = 0.002), and bowel wall thickness (I, = 0.03) were found.Conclusions: Low-field MRI seems to be a promising noninvasive method in the evaluation of response regarding both disease extension and activity in Crohn's disease during treatment with systemic steroids.