Bowel wall MRI T1 relaxation estimates for assessment of intestinal inflammation in pediatric Crohn's disease.
Bowel wall MRI T1 relaxation estimates for assessment of intestinal inflammation in pediatric Crohn's disease.
复制标题
肠壁 MRI T1 松弛估计用于评估小儿克罗恩病肠道炎症。
DOI：
10.1007/s00261-022-03560-y
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Dillman,JonathanR
中科院分区：
文献类型：
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作者：
Mahalingam,Neeraja;Tkach,JeanA;Denson,LeeA;Dillman,JonathanR
PurposeTo比较肠壁T1松弛估计在年轻患者新诊断的回肠CD健康对照参与者，其特征随时间的变化，以响应生物医学治疗，并评估其与临床标志物的肠道inflammation.Materials和methodsPatients新诊断的回肠CD和健康对照参与者之间前瞻性招募2018年12月和2021年10月。患者在基线和生物医学治疗6周和6个月时接受了肠道研究MRI检查;对照参与者接受了单一MRI检查。MRI检查包括使用改良的Look-Tumor反转恢复（MOLLI）序列对末端回肠进行自然T1弛豫测量。在扫描仪生成的参数图上测量T1估计值。在每次访视时记录肠道炎症的临床标志物。使用Mann-WhitneyU检验评估组间差异;使用Friedman检验评估T1估计值的纵向变化。斯皮尔曼相关性被用来评估T1估计和炎症markers.Results19 CD（12名男性，中位年龄14岁）和15名对照组参与者（7名男性，中位年龄17岁）之间的关联被列入研究。CD患者的肠壁T1估计值（中位数1302 ms）显著长于对照参与者（中位数1159 ms）（p< 0.001）。在CD患者中，T1估计值在治疗后随时间变化（p= 0.001），在基线和6周之间下降最大（p< 0.001）。T1估计值与炎症标志物相关，包括红细胞沉降率（ρ= 0.35;p= 0.01）、c反应蛋白水平（ρ= 0.34;p= 0.02）和加权小儿克罗恩病活动指数（ρ= 0.39;p= 0.005）。T1估计值与血清白蛋白（ρ=-0.28;p= 0.051）和粪便钙卫蛋白（ρ= 0.07;p= 0.63）不相关。
PurposeTo compare bowel wall T1 relaxation estimates in young patients with newly diagnosed ileal CD to healthy control participants, characterize their change over time in response to biologic medical therapy, and evaluate their associations with clinical markers of intestinal inflammation.Materials and methodsPatients with newly diagnosed ileal CD and healthy control participants were prospectively recruited between December 2018 and October 2021. Patients underwent research MRI examinations of the bowel at baseline and at 6-weeks and 6-months into biologic medical treatment; control participants underwent single MRI examinations. MRI examinations included native T1 relaxometry of the terminal ileum using a modified Look-Locker inversion recovery (MOLLI) sequence. T1 estimates were measured on scanner-generated parametric maps. Clinical markers of intestinal inflammation were recorded at each visit. Group differences were assessed using the Mann–WhitneyUtest; the Friedman test was used to assess longitudinal changes in T1 estimates. Spearman correlation was used to evaluate associations between T1 estimates and inflammatory markers.ResultsNineteen participants with CD (12 males; median age 14 years) and 15 control participants (7 males; median age 17 years) were included in the study. Bowel wall T1 estimates in CD patients (median 1302 ms) were significantly longer compared to control participants (median 1159 ms) (p< 0.001). In CD patients, T1 estimates changed over time after treatment (p= 0.001), with largest reductions between baseline and 6-weeks (p< 0.001). T1 estimates correlated with inflammatory markers, including erythrocyte sedimentation rate (ρ= 0.35;p= 0.01), c-reactive protein level (ρ= 0.34;p= 0.02), and weighted Pediatric Crohn’s Disease Activity Index (ρ= 0.39;p= 0.005). T1 estimates did not correlate with serum albumin (ρ= − 0.28;p= 0.051) and fecal calprotectin (ρ= 0.07;p= 0.63).ConclusionBowel wall T1 estimates are abnormally increased in newly diagnosed ileal CD patients and decrease in response to medical therapy.