磁共振小肠成像技术诊断克罗恩病的关键指标研究

Study on Key Features of Magnetic Resonance Enterography in the Diagnosis of Crohn’s Disease

目的探讨磁共振小肠成像技术(Magnetic Resonance Enterography,MRE)诊断克罗恩病(Crohn's Disease,CD)的关键影像学指标。方法回顾性分析70例CD患者的MRE影像学指标(肠壁厚度、全层强化、肠腔狭窄、弥散受限、脂肪间隙、梳子征、肠系膜淋巴结肿大、脓肿、瘘管),计算指标的灵敏度、特异度、阳性预测值、阴性预测值,以及OR值和95%置信区间(Confidence Interval,CI)。结果灵敏度和特异度前3位是全层强化(95.56%)、肠壁厚度(91.49%)和肠腔狭窄(88.00%);阳性预测值最高的前3位是肠腔狭窄88.00%、肠壁厚度86.00%、全层强化86.00%;全层强化、肠壁厚度和肠腔狭窄的OR值为2.1348、1.3378、1.1733,95%CI分别为3.5493~0.7203、2.5593~0.1162、1.98~0.3666。结论肠壁厚度、全层强化和肠腔狭窄是依据MRE诊断CD最有价值的关键指标。

Objective To investigate the key features of magnetic resonance enterography(MRE)in Crohn’s Disease(CD).Methods The MRE parameters(mural thickening,mural enhancement,intestinal stenosis,abnormal diffusion restriction,fatty proliferation,comb sign,mesenteric lymph nodes,abscess and fistula)from 70 CD patients were retrospectively analyzed.The sensitivity,specificity,positive predictive value and negative predictive value were calculated.Furthermore,their OR value and 95%confidence interval(CI)were calculated.Results The three highest sensitivity and specificity were mural enhancement(95.56%),mural thickening(91.49%)and intestinal stenosis(88.00%).The three highest positive predictive value was intestinal stenosis(88.00%),mural thickening(86.00%)and mural enhancement(86.00%).The OR values and 95%CI of mural thickening,mural enhancement and intestinal stenosis were respectively 2.1348(3.5493~0.7203),1.3378(2.5593~0.1162)and 1.1733(1.98~0.3666).Conclusion The mural thickening,mural enhancement and intestinal stenosis are the most valuable key indicators for the diagnosis of CD based on MRE.