在克朗氏病患者中检测肠炎和生物治疗反应的ADC值:后期前性试验分析
Jordi Rimola1,2, Agnès Fernandez-Clotet3, Nunzia Capozzi1,4
1Radiology Department, IBD Unit, Hospital Clínic de Barcelona, Villarroel 170, Escala 3 Planta 1, 08036, Barcelona, Spain.
AJR. American journal of roentgenology
|August 16, 2023
概括
表面扩散系数 (ADC) 值在克罗恩病 (CD) 中评估肠道炎症方面表现有前途,但在监测生物疗法反应方面并不能取代马里亚评分.
科学领域:
- 胃肠病学 胃肠病学
- 放射学 放射学是指放射学
- 医疗成像医学成像
背景情况:
- 克罗恩病 (CD) 的生物疗法需要非侵入性疾病标志物.
- 扩散权重成像 (DWI) 为评估肠道炎症提供了一种无对比剂的方法.
研究的目的:
- 评估表面扩散系数 (ADC) 值在确定接受生物治疗的CD患者的肠道炎症和治疗反应方面的有用性.
- 将ADC的诊断性能与已建立的MR活动指数 (MaRIA) 评分和内镜检测进行比较.
主要方法:
- 对前性试验数据的后期分析,包括89名接受生物治疗的CD患者.
- 在基线和46周进行MR肠道学 (MRE),其中43名患者接受了胆结肠镜检查.
- 分析了586个小肠和结直肠片段,测量了ADC值和MaRIA分数,并评估了内镜.
主要成果:
- 在基线时,ADC在检测MARIA得分≥11时表现出高准确度 (88.2%),AUC为0.92.
- 在检测内镜时,ADC表现良好 (AUC为0.87),但MaRIA得分更高 (AUC为0.96).
- 在随访时,ADC检测MARIA得分改善的准确性为80.0% (AUC0.87),愈的准确性为84.4% (AUC0.84),两者都低于MARIA得分.
结论:
- ADC值显示出作为评估CD中肠道炎症的辅助工具的潜力.
- 目前不建议使用ADC测量作为评估对生物疗法的反应的主要方法,而MaRIA得分仍然优越.
- 进一步的研究可能会完善ADC在治疗CD患者中的作用.
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