3T磁共振VIBE动态增强在小肠Crohn病诊断中的应用

目的分析磁共振小肠检查在小肠Crohn病中的表现，评估3T磁共振超快速高分辨率VIBE序列在小肠Crohn病诊断中的应用价值。方法2012年1月至2014年6月经临床诊断为Crohn病的患者40例，行常规MRJ的T2WI、DWI检查及3DVIBE冠状位多期动态增强扫描，对所获得的图像资料主要分析每一病灶的部位、肠壁厚度、肠腔狭窄、肠管直径、强化特点、并发症及周围脏器受累情况。结果40例患者均顺利完成检查，未发现并发症，最终经临床、影像学、肠镜、手术和病理检查确诊为Crohn病的患者为27例（67．5％）。VIBE动态增强图像的诊断准确率（95．8％）明显高于DWI图像的诊断准确率（86．1％）及常规T2WI加脂肪抑制的横断面、冠状面图像的诊断准确率（74．6％）。动态增强信号强化程度Crohn病变肠段明显高于正常肠段（P〈0．005）。结论3T磁共振VIBE冠状位多期动态增强扫描对小肠Crohn病的诊断具有明显的优越性，诊断准确率明显高于DWI图像和T2WI加脂肪抑制图像，是小肠MR成像中不可缺少的检查序列。

Objective To analysis the performance of magnetic resonance imaging （ MRI ） in the small intestinal Crohn＇s disease （ Crohn diseases, CD ） , and to evaluate the application value of 3T super fast speed high resolution VIBE sequence in the diagnosis of small intestinal Crohn＇s disease. Methods A retrospective analysis was used in 40 cases of clinical diagnosis as Crohn＇s disease in our hospital from January 2012 to June 2014. All of patients were recepted routine MRI T2WI, DWI examination and 3D VIBE coronary multiphase dynamic enhanced scan. We analyzed all the images including the main parts of every lesions, intestinal wall thickness, lumen stenosis, long intestinal tube diameter, strengthening the features, the complications and the surrounding organs involvement. Results 40 patients were all successfully completed with MRI inspections. No one had complications. 27 cases were confirmed of the Crohn＇s disease （ 67.5% ） eventually by clinical, radiographic, endoscopic, surgical and pathological examination. The VIBE diagnostic accuracy of dynamic contrast-enhanced images was 95.8%, significantly higher than that of DWI images （ 86.1% ） and that of routine T2WI with fat suppression images （ 74.6% ） .The dynamic signal enhancement degree of Crolm＇s disease intestinal segments were significantly higher than normal intestinal segments, P〈0.005. Conclusion 3T MRI Coronal VIBE multi-phase dynamic contrast-enhanced scanning had a unique advantage in the diagnosis of small bowel Crohn＇s disease. It had a higher diagnostic accuracy than DWI T2WI and fat inhibition images, making it an indispensable sequence in the small intestine MRI.