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目的联合磁共振定量动态增强(DCE-MRI)和磁共振扩散加权成像(DW-MRI)两种MRI功能成像对肠道克罗恩病(CD)展开研究,基于病变肠壁的病理改变,讨论MRI各功能参数值的意义及功能参数之间的相关性。方法采用前瞻性研究方法,纳入30例临床确诊的肠道CD患者,男21例,女9例;年龄15~72岁,平均(31.00±13.83)岁。根据常规MRI表现,每例患者选取一段肠管行DCE-MRI和DW-MRI,在相同病变位置勾画感兴趣区(ROI)后分别得到容积转运常数(Ktrans)、返流常数(Kep)、血管外细胞外间隙容积分数(Ve)、血浆容量(Vp)以及表观扩散系数(ADC),使用Pearson相关检验,观察Ktrans、Kep、Ve、Vp与ADC值之间的相关性。结果 30段病变肠管Ktrans值0.13~2.96 min-1,平均(1.16±0.77)min-1;Kep值0.14~3.39 min-1,平均(1.71±0.88)min-1;Ve值0.30~1.64,平均0.87±0.42;Vp值0.11~0.99,平均0.08±0.18;ADC值范围0.84~2.44×10-3mm2/s,平均(1.42±0.32)×10-3mm2/s。Ktrans与ADC的相关系数0.396,P=0.030,<0.05;Ve与ADC的相关系数0.507,P=0.004,<0.05。结论联合使用DCE-MRI和DW-MRI能反映CD患者肠壁微循环和微结构改变。
OBJECTIVE: To study the development of intestinal Crohn’s disease (CD) by combining MRI dynamic imaging with dynamic contrast-enhanced magnetic resonance (DCE-MRI) and magnetic resonance diffusion-weighted imaging (DW-MRI) The significance of each functional parameter of MRI and the correlation between functional parameters. Methods A prospective study was conducted in 30 clinically diagnosed patients with intestinal CD, including 21 males and 9 females, aged 15-72 years with an average of (31.00 ± 13.83) years. According to the conventional MRI findings, DCE-MRI and DW-MRI were selected for each patient. The ROIs were plotted at the same lesion location to obtain the Ktrans, Kep, Extracellular space volume fraction (Ve), plasma volume (Vp) and apparent diffusion coefficient (ADC) were measured. Pearson correlation test was used to observe the correlation between Ktrans, Kep, Ve, Vp and ADC values. Results The Ktrans values of intestinal tract in 30 lesions were 0.13-2.96 min-1 (mean 1.16 ± 0.77) min-1, Kep 0.14-3.39 min-1 (mean 1.71 ± 0.88) min-1 and Ve values were 0.30-1.64 0.87 ± 0.42; Vp values ranged from 0.11 to 0.99 with an average of 0.08 ± 0.18; ADC values ranged from 0.84 to 2.44 × 10-3mm2 / s with an average of (1.42 ± 0.32) × 10-3mm2 / s. The correlation coefficient between Ktrans and ADC was 0.396, P = 0.030, <0.05; the correlation coefficient between Ve and ADC was 0.507, P = 0.004, <0.05. Conclusions Combined use of DCE-MRI and DW-MRI can reflect the microcirculation and microcosmic changes of intestinal wall in patients with CD.