不同磁共振成像序列诊断炎症性肠病的价值研究

Study on diagnostic value of different MRI sequences in inflammatory bowel disease

目的:探讨不同磁共振成像(MRI)序列对炎症性肠病(IBD)的诊断价值。方法:选取医院收治的87例疑似IBD患者,行不同MRI序列及结肠镜检查,并行病理活检。以病理活检结果为“金标准”,分析不同MRI序列对IBD的诊断价值,同时分析MRI多序列联合诊断IBD与病理结果的一致性。结果:病理结果显示,87例患者中共有69例确诊为IBD,其中克罗恩病(CD)47例,溃疡性结肠炎(UC)32例,另有无明显异常8例。T_(1)加权成像(T_(1)WI)、T_(2)加权成像(T_(2)WI)、弥散加权成像(DWI)及增强扫描的诊断灵敏度分别为84.81%、87.34%、91.14%及93.67%,特异度分别为75.00%、62.50%、87.50%及100.00%。MRI多序列联合检测诊断灵敏度为96.20%,特异度为100.00%。Kappa一致性检验结果显示,T_(1)WI及T_(2)WI与病理检测结果一致性较差(Kappa=0.383,Kappa=0.358),DWI及增强扫描与病理检测结果一致性一般(Kappa=0.654,Kappa=0.731)。MRI不同序列联合检测与病理检测结果一致性较好(Kappa=0.823)。结论:MRI不同序列联合应用于IBD筛查可以提高疾病诊断效率,且与病理结果具有较高的一致性,具有一定临床诊断价值。

Objective:To investigate the diagnostic value of different magnetic resonance imaging(MRI)sequences for inflammatory bowel disease(IBD).Methods:A total of 87 patients who admitted to hospital were selected,and they underwent different MRI sequences,colonoscopy and pathological biopsy.Taking the results of pathological biopsy as the"gold standard",the diagnostic values of different MRI sequences for IBD were analyzed,and the accuracy of the combined diagnosis of MRI multi-sequences for IBD was further analyzed.Results:In the 87 IBD patients,the pathological results indicated that 69 cases were confirmed as IBD included 47 cases of Crohn's disease(CD),32 cases of ulcerative colitis(UC),and 8 cases without obvious abnormality.The sensitivities of T_(1) weight imaging(T_(1)WI)and T_(2) weight imaging(T_(2)WI),diffusion weight imaging(DWI)and enhanced scan were respectively 84.81%,87.34%,91.14%and 93.67%,and the specificities of them were respectively 75.00%,62.50%,87.50%and 100.00%.The results of Kappa consistency test indicated that the consistencies between T_(1)WI and pathological test,and between T_(2)WI and pathological test were relatively poor(Kappa=0.383,Kappa=0.358),and the consistency between DWI and pathological test,and between enhanced scan and pathological test were general(Kappa=0.654,Kappa=0.731).The consistency between the combined detection of different MRI sequences and the pathological test was favorable(Kappa=0.823).Conclusion:The combined application of different MRI sequences can improve the efficiency of disease diagnosis in IBD screening,and it has higher consistency with the pathological results,which has certain clinical application value.