3.0T MR-DWI评估溃疡性结肠炎可行性的初步研究

目的 探讨3.0 T MR-扩散加权成像(DWI)评估溃疡性结肠炎(ulcerative colitis,UC)病变肠管的可行性并比较UC病变肠管与非病变肠管和正常对照组肠壁间表观扩散系数(ADC)值的差异.资料与方法 对经病理证实的UC 13例和20例无炎症性肠病者(正常对照组)进行回顾性分析,观察各段肠管(直肠、降结肠、横结肠、升结肠、盲肠)的DWI图像及ADC图表现并测量ADC值,将病变组评估结果与内镜及病理所见相对照,计算其检出病变肠段的敏感性及特异性.结果 对13例共75段肠管进行分析；内镜及病理证实55段呈炎性改变,20段未见异常；DWI结果真阳性51段,真阴性17段,检出敏感性和特异性分别为92.7％和85.0％.病变段和非病变段肠壁ADC值分别为(1.63±0.4)×10-3mm2/s和(2.48±0.61)×10-3mm2/s,二者差异具有统计学意义(P＜0.001),但非病变段肠壁ADC值与正常对照组肠壁[(2.27 ±0.6)×10-3mm2/s]间差异无显著统计学意义(P＞0.05).结论 MR-DWI评估UC及判断病变范围较为可靠,并具有可行性.

A Preliminary Study of Diffusion Weighted Imaging in Detection Bowel Inflammation in Patients with Ulcerative Colitis Using 3.0 T MRI

Objective To study the feasibility of diffusion weighted imaging(DWI) in detection of bowel inflammation and to compare the difference of apparent diffusion coefficient(ADC) values in the bowel inflammatory group and non inflammatory group.Materials and Methods Thirteen patients with ulcerative colitis confirmed by pathology and 20 normal volunteers were collected in the study.The DWI image and ADC values in each segment(cecum,ascending colon,transverse colon,descending colon,sigmoid,rectum) were analyzed and measured retrospectively.The ADC values in ulcerative colitis group were compared with endoscopic and pathological findings.Sensitivity and specificity were calculated.Results seventy five segments(55 with inflammation,20 normal proved by pathology) were included in the study.The true positive and true negative segments detected by DWI were 51 and 17.The sensitivity and specificity were 92.7% and 85.0%,respectively.ADC values of inflamed and normal bowel were(1.63±0.4)×10-3mm2/s and(2.48±0.61)×10-3mm2/s.There was statistically significant difference of the ADC values between the inflammation and normal segments(P < 0.001)in ulcerative colitis group.But there was no statistically significant difference of ADC values between non inflammatory in ulcerative colitis group and normal controal group(P>0.05).Conclusion DWI is a reliable and viable technology in assessing ulcerative colitis and the extention in patients with inflammatory lesions.