Can Dynamic Contrast-Enhanced MRI (DCE-MRI) and Diffusion-Weighted MRI (DW-MRI) Evaluate Inflammation Disease: A Preliminary Study of Crohn's Disease.
Can Dynamic Contrast-Enhanced MRI (DCE-MRI) and Diffusion-Weighted MRI (DW-MRI) Evaluate Inflammation Disease: A Preliminary Study of Crohn's Disease.
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DOI：
10.1097/md.0000000000003239
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发表时间：
2016-04
期刊：
影响因子：
1.6
通讯作者：
Wang D
中科院分区：
文献类型：
--
作者：
Zhu J;Zhang F;Luan Y;Cao P;Liu F;He W;Wang D
目的探讨MRI动态增强扫描（DCE-MRI）和弥散加权成像（DW-MRI）对克罗恩病（CD）的诊断价值。目的：探讨功能磁共振成像参数Ktranss、Kep、Ve、Vp和表观扩散系数（ADC）与血清学标志物的相关性。并对药动学参数与ADC值的关系进行了研究。32例CD患者（22例男性，10例女性;平均年龄：30.5岁）和18例无任何炎症性疾病的健康志愿者（10例男性，8例女性;平均年龄：34.11岁）入组本获批前瞻性研究。Pearson相关分析Ktranss、Kep、Ve、Vp与C反应蛋白（CRP）、ADC、CRP的相关性。通过受试者工作特征曲线（ROC）分析功能MRI参数在敏感性和特异性方面的诊断效力。根据Youden标准确定每个功能MRI参数用于区分炎症和正常肠的最佳截止值。CD组Ktranss均值明显高于正常对照组。对于Kep和Ve观察到类似的结果。CD组ADC值低于对照组。Ktranss、Ve与CRP相关（r = 0.725，P <0.001; r = 0.533，P = 0.002），ADC与CRP呈负相关（r =-0.630，P <0.001）。 药代动力学参数与ADC呈负相关，如Ktranss与ADC呈负相关（r =-0.856，P <0.001），Ve与ADC呈负相关（r =-0.451，P = 0.01）。 曲线下面积（AUC）分别为Ktrans0.994（P <0.001）、ADC 0.905（P <0.001）、Ve 0.806（P <0.001）和Kep 0.764（P = 0.002）。 发现Ktranss的截止点为0.931 min-1。该值提供了灵敏度（93.8%）和特异性（100%）之间的最佳权衡。ADC的最佳截止点为1.11 × 10-3 mm 2/s。 在此水平上，敏感性为100%，特异性为68.8%。DCE-MRI和DW-MRI有助于CD的诊断。定量MRI参数可用于评估炎症的严重程度。药代动力学参数（Ktranss和Ve）与ADC的关系在一定程度上反映了CD的微结构和微循环。
The aim of the study was to investigate diagnosis efficacy of dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted MRI (DW-MRI) in Crohn's disease (CD). To find out the correlations between functional MRI parameters including Ktrans, Kep, Ve, Vp, and apparent diffusion coefficient (ADC) with a serologic biomarker. The relationships between pharmacokinetic parameters and ADC were also studied. Thirty-two patients with CD (22 men, 10 women; mean age: 30.5 years) and 18 healthy volunteers without any inflammatory disease (10 men, 8 women; mean age, 34.11 years) were enrolled into this approved prospective study. Pearson analysis was used to evaluate the correlation between Ktrans, Kep, Ve, Vp, and C-reactive protein (CRP), ADC, and CRP respectively. The diagnostic efficacy of the functional MRI parameters in terms of sensitivity and specificity were analyzed by receiver operating characteristic (ROC) curve analyses. Optimal cut-off values of each functional MRI parameters for differentiation of inflammatory from normal bowel were determined according to the Youden criterion. Mean value of Ktrans in the CD group was significantly higher than that of normal control group. Similar results were observed for Kep and Ve. On the contrary, the ADC value was lower in the CD group than that in the control group. Ktrans and Ve were shown to be correlated with CRP (r = 0.725, P < 0.001; r = 0.533, P = 0.002), meanwhile ADC showed negative correlation with CRP (r = −0.630, P < 0.001). There were negative correlations between the pharmacokinetic parameters and ADC, such as Ktrans to ADC (r = −0.856, P < 0.001), and Ve to ADC (r = −0.451, P = 0.01). The area under the curve (AUC) was 0.994 for Ktrans (P < 0.001), 0.905 for ADC (P < 0.001), 0.806 for Ve (P < 0.001), and 0.764 for Kep (P = 0.002). The cut-off point of the Ktrans was found to be 0.931 min–1. This value provided the best trade-off between sensitivity (93.8%) and specificity (100%). The best cut-off point of ADC was 1.11 × 10–3 mm2/s. At this level, sensitivity was 100% and specificity was 68.8%. DCE-MRI and DW-MRI were helpful in the diagnosis of CD. Quantitative MRI parameters could be used to assess the severity of inflammation. The relationships between pharmacokinetic parameters (Ktrans and Ve) and ADC reflected microstructure and microcirculation of CD to some extent.