对于描述纤维增性克罗恩病的MR肠道学特征的可靠性
Florian Rieder1, Mark E Baker1, David H Bruining1
1From the Department of Inflammation and Immunity, Lerner Research Institute (F.R., R.O., N.A.), Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases (F.R., M.T.S., V.C.S.), and Program for Global Translational Inflammatory Bowel Disease Research (F.R., R.O.), Cleveland Clinic Foundation, Cleveland, Ohio; Section of Abdominal Imaging, Imaging, Digestive Diseases and Surgery and Cancer Institutes (M.E.B.) and Department of Diagnostic Radiology (J.M.R.) Cleveland Clinic Foundation, Cleveland, Ohio; Division of Gastroenterology and Hepatology (D.H.B.), Biomedical Imaging Resource (D.R.H.), and Department of Radiology (J.L.F., E.C.E., S.P.S., J.P.H., D.R.H., Y.S.L., J.G.F.), Mayo Clinic, 200 First St, Rochester, MN 55905; Department of Radiology, Shiga University of Medical Science, Shiga, Japan (A.I.); Department of Radiology, University of Texas Medical Branch, Galveston, Tex (P.M.); Centre for Medical Imaging, University College London, London, United Kingdom (S.A.T.); Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, the Netherlands (J.S.); Alimentiv, London, Ontario, Canada (G.Z., Z.W., J. Rémillard, C.M., C.E.P., V.J., B.G.F.); Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada (G.Z., V.J., B.G.F.); Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Fla (R.E.C.); Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada (C.M.); Departments of Gastroenterology (J.P.) and Radiology (J. Rimola), Hospital Clínic de Barcelona, Barcelona, Spain; and Department of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada (V.J., B.G.F.).
这项研究开发并验证了MR肠道学标准,用于评估克罗恩病狭窄性. 这些成像定义可靠地与收缩严重程度相关,有助于临床决策和药物开发.
科学领域:
- 胃肠病学 胃肠病学
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 纤维化克罗恩病的管理受限于缺乏标准化的成像定义和验证的终点.
- 目前的临床决策和克罗恩病狭窄症的药物开发受到这种诊断差距的阻碍.
研究的目的:
- 为了建立可靠的磁共振 (MR) 肠道学特征来描述克罗恩病的狭窄性.
- 为了确定这些MR肠道学特征与狭窄症的严重程度之间的相关性.
主要方法:
- 在患有症状终端质性克罗恩病狭窄的患者中,对MR肠道检查的回顾性分析.
- 放射科医生在开发阶段使用类内相关系数 (ICC) 独立评估了26个MR肠道学特征的可靠性.
- 在一个独立的验证样本中重新定义了特征,重新估计了可靠性;多变量回归确定了与狭窄严重程度相关的特征.
主要成果:
- 在开发阶段,九个MR肠道学特征至少表现出中等级别的评分器间可靠性 (ICC ≥0.41).
- 狭窄的长度和最大相关的小肠扩张显示了最高的interrater可靠性.
- 狭窄的长度,最大的狭窄壁厚度和最大的相关小肠扩张独立地与狭窄的严重程度相关 (P < .001).
结论:
- 成功开发和验证了MR肠道学定义和评分惯例,用于评估克罗恩病狭窄性.
- 该研究确定了可靠的成像特征,与收缩严重程度相关,改善了诊断能力.
- 这些发现支持加强临床决策和开发治疗纤维化克罗恩病的药物.
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