摘要
目的探讨DWI及ADC值对克罗恩病(CD)活动性的诊断价值。方法回顾性分析47例CD患者的常规磁共振肠造影(MRE)及DWI表现,观察病变肠段的肠壁厚度、T2WI信号、强化程度和DWI信号并进行量化评分(0~3分)。通过ADC图测量肠段ADC值。以克罗恩病活动指数(CDAI)为疾病活动性参考标准,分析DWI及ADC值与CD活动性的关系。结果 47例患者中活动期(CDAI≥150)25例,缓解期(CDAI<150)22例。活动期CD的DWI信号评分高于缓解期(P<0.001);活动期CD病变肠壁的ADC值低于缓解期者(P<0.01)。DWI信号评分与CDAI呈正相关(r=0.74,P<0.001);病变肠段ADC值与CDAI呈负相关(r=-0.71,P<0.001)。ROC曲线分析显示ADC值及DWI信号评分诊断CD活动性的曲线下面积(AUC)较大,分别为0.98和0.91;选择ADC值1.17×10^(-3) mm^2/s为阈值时,诊断敏感度为100%,特异度为88.0%。结论通过DWI信号评分及其ADC值均可较准确地判断CD活动性。
Objective To assess the diagnostic value of DWI and ADC in evaluating activity of Crohn disease（CD）.Methods Conventional MR enterography（MRE）and DWI findings of 47 patients with CD were retrospectively analyzed.Mural thickness,T2 WI signal intensity,contrast enhancement and DWI signal intensity were qualitatively scored respectively（0-3）.ADC values were measured in bowel wall on ADC maps.Taking Crohn disease activity index（CDAI）as reference of CD activity,the relationships between CDAI and both of DWI signal intensity and ADC value were analyzed.Results There were 25 cases of active CD（CDAI≥150）and 22 cases of inactive CD（CDAI〈150）.DWI score of active CD was significantly higher than that of inactive CD（P〈0.001）.ADC value in inflamed segment of active CD was significantly lower than that of inactive CD（P〈0.001）.DWI signal intensity correlated positively with CDAI（r=0.74,P〈0.001）while there was negative correlation between ADC value and CDAI（r=-0.71,P〈0.001）.ADC value and DWI signal intensity showed well diagnostic accuracy for CD activity with ROC analysis（AUC=0.98,0.91,respectively）.Taking ADC value of 1.17×10^（-3） mm^2/s as threshold,the diagnostic sensitivity and specificity was 100% and 88.0%,respectively.Conclusion Both of DWI and ADC value are helpful to diagnose the activity of Crohn disease with high accuracy.
出处
《中国医学影像技术》
CSCD
北大核心
2016年第4期547-551,共5页
Chinese Journal of Medical Imaging Technology
基金
广东省科技计划项目(2014A020212480)
关键词
扩散磁共振成像
克罗恩病
活动性
Diffusion magnetic resonance imaging
Crohn disease
Activity
