Crohn Disease: A 5-Point MR Enterocolonography Classification Using Enteroscopic Findings
Crohn Disease: A 5-Point MR Enterocolonography Classification Using Enteroscopic Findings
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DOI：
10.2214/ajr.17.18897
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发表时间：
2019-01-01
影响因子：
5
通讯作者：
Tateisi, Ukihide
中科院分区：
文献类型：
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作者：
Kitazume, Yoshio;Fujioka, Tomoyuki;Tateisi, Ukihide
OBJECTIVE.我们研究的目的是建立5点MR肠结肠造影分类评估克罗恩病（CD）活动性的有效性，将该分类与经验证的MRI蔑视（即，MR活动指数[MaRIA]），并与内镜检查结果进行比较，内镜检查结果采用克罗恩病内镜严重程度指数（CDEIS）进行评估。本研究回顾性入组了70例（推导队列）和50例（验证队列）CD患者。我们开发了一个5点MR肠结肠成像分类，仅包括视觉评估。在推导阶段由一名观察者评价每个肠段（直肠;乙状结肠、降横结肠和升结肠;回肠末端和近端;以及空肠）的MR肠结肠成像结果，在验证阶段由三名观察者使用5点MR肠结肠成像分类词典和MaRIA独立评价。比较了MR肠结肠成像分类和MaRIA在鉴别内镜下深部溃疡方面的ROC曲线下面积（AUC）。使用加权kappa系数评估观察者间重现性。在推导阶段，MR肠结肠造影分类的AUC为890%，在验证阶段，三名观察员的AUC分别为88.5%、81.0%和77.3%。MR小肠结肠造影分类的AUC在统计学上不劣于MaRIA分类的AUC（p < 0.001）。交叉验证的准确率在推导阶段为81.9%，在验证阶段为81.5%。MR小肠结肠造影分型具有良好的重复性。5点MR肠结肠造影分类被证明是有效的评估CD活动在大肠和小肠。
OBJECTIVE. The objectives of our study were to establish the efficacy of a 5-point MR enterocolonography classification for assessing Crohn disease (CD) activity, compare this classification with a validated MRI scorn (i.e., the MR index of activity [MaRIA]), and compare both with endoscopic findings, which were assessed using the Crohn disease endoscopic index of severity (CDEIS).MATERIALS AND METHODS. Seventy (derivation cohort) and 50 (validation cohort) patients with CD were retrospectively enrolled in this study. We developed a 5-point MR enterocolonography classification that consists of visual assessments alone. MR enterocolonography results were evaluated for each bowel segment (rectum; sigmoid, descending transverse, and ascending colon; terminal and proximal ileum; and jejunum) by one observer in the derivation phase and independently by three observers in the validation phase using the 5-point MR enterocolonography classification lexicon and MaRIA. Areas under the ROC curves (AUCs) in discriminating endoscopic deep ulcers were compared between the MR enterocolonography classification and MaRIA. Interobserver reproducibility was assessed using weighted kappa coefficients.RESULTS. The AUCs of the MR enterocolonography classification were 890% in the derivation phase and 88.5%, 81.0%, and 77.3% for the three observers in the validation phase. The AUCs of the MR enterocolonography classification were statistically noninferior to those of MaRIA (p < 0.001). The cross-validation accuracy was 81.9% in the derivation phase and 81.5% in the validation phase. The MR enterocolonography classification showed good reproducibility.CONCLUSION. The 5-point MR enterocolonography classification was shown to be effective for evaluating CD activity in the large and small bowel.