>
网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
CT与MR造影对小肠克罗恩病诊断价值比较的Meta分析
作者:徐孝新  陈洪 
单位:东南大学附属中大医院 消化科, 江苏 南京 210009
关键词:克罗恩病 计算机断层扫描造影 磁共振造影 Meta分析 
分类号:R445.2;R814.42;R574.5
出版年·卷·期(页码):2019·38·第二期(223-229)
摘要:

目的:采用Meta分析比较计算机断层扫描成像技术(CTE)与磁共振成像(MRE)对小肠克罗恩病(CD)的诊断价值。方法:检索数据库并收集关于CTE及MRE诊断小肠CD的文献,进行统计分析得到CTE及MRE两组诊断试验的合并敏感度、特异度、诊断比值比(DOR)及受试者工作特征曲线的曲线下面积(AUC),比较两者对小肠CD的诊断效能以及活动性和并发症的检测能力。结果:CTE组合并敏感度、特异度和DOR分别为81%、82%和16.67,而MRE组分别为88%、90%和40.58,两组的AUC分别为0.8728和0.894 5。采用Z检验比较两组的诊断效能,差异无统计学意义(Z=1.65,P>0.05)。且CTE与MRE对CD并发症(如狭窄、瘘管、脓肿等)及活动性的检测能力差异无统计学意义。结论:CTE与MRE对于CD具有良好的、相似的诊断能力,同时对活动性及并发症的检测能力无显著区别。

Objective:To compare the diagnostic value of computed tomography enterography (CTE) and magnetic resonance enterography(MRE) for small bowel Crohn disease (CD)by Meta-analysis. Methods:The databases were systematically searched for relevant articles on the diagnosis of CD using CTE or MRE. Data were pooled to yield summary sensitivity, specificity and the area under the SROC curve (AUC).Then they were compared in the diagnostic efficacy and the detectability of activity and complications. Results:The pooled sensitivity,specificity,DOR of CTE and MRE was 81%,82%,16.67 and 88%,90%,40.58.The AUC of CTE and MRE was 0.8728 and 0.894 5.The results of Z-test revealed there were no significant differences in diagnostic performance between CTE and MRE.There was no statistically significant difference between CTE and MRE in detecting CD complications(such as stenosis,abscess and fistula)and activity. Conclusion:CTE and MRE have high and similar performance in diagnosis of CD,and there is no significant difference in the detection abilities of activity and complications.

参考文献:

[1] SIDDIKI H,FLETCHER J G,HARA A K,et al.Validation of a lower radiation computed tomography enterography imaging protocol to detect Crohn's disease in the small bowel[J].Inflamm Bowel Dis,2011,17:778-786.
[2] FIDLER J L,GUIMARAES L,EINSTEIN D M.MR imaging of the small bowel[J].Radiographics,2009,29(6):1811-1825.
[3] DEL VESCOVO R,SANSONI I,CAVIGLIA R,et al.Dynamic contrast enhanced magnetic resonance imaging of the terminal ileum:differentiation of activity of Crohn's disease[J].Abdom Imaging,2008,33:417-424.
[4] BRUINING D H,ZIMMERMANN E M,LOFTUS E V,et al.Consensus recommendations for evaluation,interpretation,and utilization of computed tomography and magnetic resonance enterography in patients with small bowel Crohn's disease[J].Radiology,2018,286(3):776-799.
[5] AMITAI M M,RAVIV-ZILKA L,HERTZ M,et al.Main imaging features of Crohn's disease:agreement between MR-enterography and CT-enterography[J].IMAJ,2015,17(5):293-297.
[6] MALGRAS B,SOYER P,BOUDIAF M,et al.Accuracy of imaging for predicting operative approach in Crohn's disease[J].Br J Surgery,2012,99(7):1011.
[7] JENSEN M D,NATHAN T,KJELDSEN J.Inter-observer agreement for detection of small bowel Crohn's disease with capsule endoscopy[J].Inflamm Bowel Dis,2011,17(5):1081-1088.
[8] JENSEN M D,NATHAN T,RAFAELSEN S R,et al.Diagnostic accuracy of capsule endoscopy for small bowel Crohn's disease is superior to that of MR enterography or CT enterography[J].Clin Gastroenterol Hepatol,2011,9(2):124.
[9] JENSEN M D,KJELDSEN J,RAFAELSEN S R,et al.Diagnostic accuracies of MR enterography and CT enterography in symptomatic Crohn's disease[J].Scand J Gastroentero,2011,46(12):1449-1457.
[10] FIORINO G,BONIFACIO C,PEYRINBIROULET L,et al.Prospective comparison of computed tomography enterography and magnetic resonance enterography for assessment of disease activity and complications in ileocolonic Crohn's disease[J].Inflamm Bowel Dis,2011,17(5):1073.
[11] SCHMIDT S,GUIBAL AMEUWLY J Y,MICHETTI P,et al.Acute complications of Crohn's disease:comparison of multidetector-row computed tomographic enterography with magnetic resonance enterography[J].Digestion,2010,82(4):229-238.
[12] SIDDIKI H A,FIDLER J L,FLETCHER J G,et al.Prospective comparison of state-of-the-art MR enterography and CT enterography in small-bowel Crohn's disease[J].AJR,2009,193(1):113.
[13] LEE S S,KIM A Y,YANG S K,et al.Crohn disease of the small bowel:comparison of CT enterography,MR enterography,and small-bowel follow-through as diagnostic techniques[J].Radiology,2009,251(3):751.
[14] MINORDI L M,VECCHIOLI A,POLONI G,et al.Enteroclysis CT and PEG-CT in patients with previous small-bowel surgical resection for Crohn's disease:CT findings and correlation with endoscopy[J].Eur J Radiol,2009,19(10):2432.
[15] MINORDI L M,VECCHIOLI A,POLONI G,et al.CT enteroclysis:multidetector technique (MDCT) versus single-detector technique (SDCT) in patients with suspected small-bowel Crohn's disease[J].La Radiologia Medica,2007,112(8):1188-1200.
[16] OZTURK E,CAKIR O,MUTLU H,et al.Diagnostic value of CTE in patients with Crohn's disease[J].Clin Imaging,2007,31(3):185-188.
[17] MINORDI L M,VECCHIOLI A,GUIDI L,et al.Multidetector CT enteroclysis versus barium enteroclysis with methylcellulose in patients with suspected small bowel disease[J].Eur J Radiol,2006,16(7):1527-1536.
[18] 左影,王鹏,黄伟,等.克罗恩病CT与MR小肠成像诊断技术的比较[J].中国医学计算机成像杂志,2016,22(4):321-326.
[19] 徐安涛,冯琦,戴张晗,等.计算机断层扫描肠道成像与小肠镜对小肠克罗恩病检出的一致性[J].中华消化杂志,2014,34(4):240-243.
[20] 张琳,汤光宇,李伟,等.多层螺旋CT小肠造影对克罗恩病的诊断价值[J].同济大学学报(医学版),2012,33(5):71-74.
[21] HORJE C S H T,BRUIJNEN R,ROOVERS L,et al.Contrast enhanced abdominal ultrasound in the assessment of ileal inflammation in Crohn's disease:a comparison with MR enterography[J].PLoS One,2015,10(8):e0136105.
[22] CASTIGLIONE F,MAINENTI P P,de PALMA G D,et al.Noninvasive diagnosis of small bowel Crohn's disease:direct comparison of bowel sonography and magnetic resonance enterography[J].Inflamm Bowel Dis,2013,19(5):991-998.
[23] WIARDA B M,MENSINK P B F,HEINE D G N,et al.Small bowel Crohn's disease:MR enteroclysis and capsule endoscopy compared to balloon-assisted enteroscopy[J].Abdom Imaging,2012,37(3):397.
[24] ALBERT J G,MARTINY F,KRUMMENERL A,et al.Diagnosis of small bowel Crohn's disease:a prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis[J].Dig World Core Med.J,2006,54(12):1721.
[25] 边向聪,陈嘉屿,王彪猛,等.CT小肠造影研究进展[J].医学综述,2017,23(7):1369-1373.
[26] YOUNG B M,FLETCHER J G,BOOYA F,et al.Head-to-head comparison of oral contrast agents for cross-sectional enterography:small bowel distention,timing,and side effects[J].J Comput Assist Tomogr,2008,32(1):32-38.
[27] KUEHLE C A,AJAJ W,LADD S C,et al.Hydro-MRI of the small bowel:effect of contrast volume,timing of contrast administration,and data acquisition on bowel distention[J].AJR Am J Roentgenol,2006,187(4):375-385.
[28] GALLEGO JOSE C,ECHARRI ANA I,PORTA A,et al.Ileal Crohn's disease:MRI with endoscopic correlation[J].Eur J Radiol,2011,80:e8-e12.
[29] YUKSEL ELIF S,IPEK S,TOPAL F,et al.Assessment of presence and grade of activity in ileal Crohn's disease[J].Turkish J Gastroenterol,2014,25:264-270.
[30] PUNWANI S,RODRIGUEZ-JUSTO M,BAINBRIDGE A,et al.Mural inflammation in Crohn disease:location-matched histologic validation of MR imaging features[J].Radiology,2009,252:712-720.
[31] LAWRANCE I C,WELMAN C J,SHIPMAN P,et al.Correlation of MRI-determined small bowel Crohn's disease categories with medical response and surgical pathology[J].World J Gastroenterol,2009,15:3367-3375.
[32] FORNASA F,BENASSUTI C,BENAZZATO L.Role of magnetic resonance enterography in differentiating between fibrotic and active inflammatory small bowel stenosis in patients with Crohn's disease[J].J Clin Imaging Sci,2011,1:35.
[33] CHIOREAN M V,SANDRASEGARAN K,SAXENA R,et al.Correlation of CT enteroclysis with surgical pathology in Crohn's disease[J].Am J Gastroenterol,2007,102:2541-2550.
[34] ADLER J,PUNGLIA D R,DILLMAN J R,et al.Computed tomography enterography findings correlate with tissue inflammation,not fibrosis in resected small bowel Crohn's disease[J].Inflamm Bowel Dis,2012,18:849-856.
[35] KAMBADAKONE A R,CHAUDHARY N A,DESAI G S,et al.Low-dose MDCT and CT enterography of patients with Crohn disease:feasibility of adaptive statistical iterative reconstruction[J].AJR Am J Roentgenol,2011,196:W743-W752.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 412689 位访问者


copyright ©《东南大学学报(医学版)》编辑部
联系电话:025-83272481 83272483
电子邮件:
bjb@pub.seu.edu.cn

苏ICP备09058364