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Correlation of MRI-determined small bowel Crohn’s disease categories with medical response and surgical pathology

查看全文 作　　者：Ian Craig [1,2]Lawrance;Christopher J [3]Welman;Peter [3]Shipman;Kevin [4]Murray 高影响力作者 机构地区：[1]School of Medicine and Pharmacology, University of Western Australia,Fremantle Hospital, WA 6160, Australia;[2]Department of Gastroenterology,Fremantle Hospital, WA 6160, Australia;[3]Department of Radiology,Fremantle Hospital, WA 6160, Australia;[4]Statistical Consulting Group, School of Mathematics and Statistics, University of Western Australia,WA 6160, Australia高影响力机构 出　　处：《World Journal of Gastroenterology》索引2009年第15卷第27期,共9页高影响力期刊 摘　　要：AIM: To determine whether magnetic resonance imaging (MRI) can be used to categorize small bowel Crohn's disease (SB CD) into groups that correlate with response to medical therapy and surgical pathology.METHODS: Data was collected from all patients with MRI evidence of SB CD without significant colonic disease over a 32-mo period. Two radiologists, blinded to clinical findings, evaluated each MRI and grouped them based on bowel wall thickness and wall enhancement. These categories were: (1) 'fibrosis', (2) 'mild segmental hyper-enhancement and mild wall thickening', (3) 'mild segmental hyper-enhancement and marked wall thickening', (4) 'marked segmental transmural hyper-enhancement'. Patient response to additional medical therapy post-MRI was prospectively determined at 8-wk. Non-responders underwent endoscopy and were offered therapeutic endoscopy or surgery. Surgical pathology was assessed against the MRI category. RESULTS: Fifty-five patients were included. Females and category '2' patients were more likely, and patients with luminal narrowing and hold-up less likely, to respond to medical therapy (P < 0.05). Seventeen patients underwent surgery. The surgical pathologicalfindings of fibrosis and the severity of inflammation correlated with the MRI category in all cases.CONCLUSION: Our fi ndings suggest that SB CD can be grouped by the MRI f indings and that these groups are associated with patients more likely to respond to continued medical therapy. The MRI categories also correlated with the presence and level of intestinal inflammation and fibrosis on surgical pathology, and may be of prognostic use in the management of CD patients. 关 键 词：病理反应 MRI 小肠 外科 医疗
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