克罗恩病CT与MR小肠成像诊断技术的比较

Comparison of CT and MR Enterography in Diagnosis of Crohn's Disease

目的:比较计算机断层摄影小肠成像(CTE)与磁共振肠管成像(MRE)在检测克罗恩病肠壁炎症和肠外表现的准确性和两种检查方法的图像质量。方法:54例克罗恩病患者分别进行CTE(33例)和MRE(21例)检查,并均行肠镜检查。回顾性分析CTE与MRE图像肠壁炎症和肠外表现。以肠镜为标准,计算比较CTE和MRE对于克罗恩病CD肠壁炎症及肠外表现检测的敏感性、特异性,以及CTE和MRE肠管炎症各种异常征象的敏感性。将图像伪影程度分为5个等级,对CT与MR图像质量进行评分。运用Fisher检验比较两种检查方法图像伪影程度的差异。结果:CTE检测克罗恩病肠壁炎症的敏感性为90%(CI67.9%,99.6%),特异性为92.3%(CI 62.1%,99.6%),MRE检测克罗恩病肠壁炎症的敏感性为88.2%(CI62.3%,97.9%),特异性为75%(CI 21.9%,97.9%),两者差别无统计学意义。MRE图像伪影分值高于CTE图像(P<0.05)。结论:CTE和MRE在检测克罗恩病肠壁炎症上具有相同的精确性,CTE图像质量好于MRE。

Purpose：To compare the accuracy and image quality of computed tomography（CT） and magnetic resonance（MR） enterography examination in detection of intestinal inflammation and extra-enteric complication in patients with Crohn＇s disease（CD）. Methods： Fifty-four patients who were with suspected CD undergone CT and MR enterography, and enteroscopy examination. The CT and MR enterography images were reviewed for detection of intestinal transmural inflammation and extra-enteric complications. Taken enteroscopy results as the reference standard, the sensitivity and specificity of CT and MR enterography in detection of intestinal transmural inflammation and extraenteric complications were calculated and compared by using the Fisher test. Sensitivity of various signs on CT and MR images for detection intestinal transmural inflammation were compared. The degrees of artifacts in the images of CTE and MRE, which were classified into 5 levels by radiologists, were compared. Results： Sensitivity and specificity of CTE in detection CD intestinal transmural inflammation was 90%（CI 67.9%, 99.6%） and 92.3%（CI 62.9%, 99.6%）; Sensitivity and specificity of MRE in detection CD intestinal transmural inflammation was 88.2%（CI 62.3%,97.9%） and 75%（CI 21.9%, 98.7%）. There was no significant difference between CTE and MRE. Sensitivities of the various signs on CTE and MRE images for detect intestinal transmural inflammation had no significant difference. MRE yielded more artifacts than CTE（P〈0.05）. Conclusion： CT enterography and MR enterography have the same accuracy in detecting CD. CTE has better image quality than MRE.