Crohn disease: magnetic resonance enterocolonography features of endoscopic ulcer stages reclassified with the healing process and the relationships to prognoses
Crohn disease: magnetic resonance enterocolonography features of endoscopic ulcer stages reclassified with the healing process and the relationships to prognoses
复制标题
DOI：
10.1007/s11604-020-01082-5
复制
发表时间：
2021-01-13
影响因子：
2.1
通讯作者：
Tateisi, Ukihide
中科院分区：
文献类型：
--
作者：
Kitazume, Yoshio;Takenaka, Kento;Tateisi, Ukihide
目的比较磁共振小肠结肠成像（MREC）在内镜下溃疡分期（包括溃疡愈合期）中的表现，并评估克罗恩病（CD）的发病情况。方法回顾性分析89例CD患者的MREC和回结肠镜或气囊辅助肠镜检查结果。患者被重新分类为38例无深部溃疡，7例愈合的深部溃疡，44例活动性深部溃疡阶段。评估了来自5分MR分类的MREC评分和MR活动指数（MaRIA），并对患者进行了随访。结果深部溃疡愈合组的MREC评分和MaRIA评分高于无深部溃疡组（p < 0.001），低于活动性深部溃疡组（p < 0.001）。无深部溃疡、愈合的深部溃疡和活动性深部溃疡的5年累积住院率分别为24.9%、0和52.4%（p < 0.05）。MREC评分或MaRIA阳性患者5年累计住院率高于阴性患者（分别为p < 0.01和p < 0.05）。结论MREC评分能反映患者的愈合阶段，对患者预后的判断具有重要意义。MREC对CD的预后有一定的预测价值。
Purpose This study aimed to compare magnetic resonance enterocolonography (MREC) features among the endoscopic ulcer stages reclassified to include healing ulcers and to assess the prognoses in Crohn disease (CD).Methods Altogether, 89 consecutive patients with CD who had undergone MREC and ileocolonoscopy or balloon-assisted enteroscopy were retrospectively studied. Patients were reclassified into 38 patients with no deep ulcer, seven with healing deep ulcer, and 44 with active deep ulcer stage. MREC score derived from a 5-point MR classification and MR index of activity (MaRIA) were evaluated, and patients were followed-up. The primary endpoint was hospitalization.Results Healing deep ulcers had higher values in MREC score and MaRIA than no deep ulcers (p < 0.001), and lower values than active deep ulcers (p < 0.001). The 5-year cumulative rates of hospitalization for no deep ulcer, healing deep ulcer, and active deep ulcers were 24.9, 0, and 52.4% (p < 0.05), respectively. MREC score or MaRIA-positive patients had a higher 5-year cumulative rate of hospitalization than the negative patients (p < 0.01 and p < 0.05, respectively).Conclusion MREC could reflect the healing stages, and the identification was revealed to be important because of the good prognosis. MREC might be useful to predict prognosis of CD.