MRI characteristics of proctitis in Crohn's disease on perianal MRI

作者：Nolthenius Charlotte J Tutein^*; Bipat Shandra; Mearadji Banafsche; Spijkerboer Anje M; Ponsioen Cyriel Y; van Swijndregt Alexander D Montauban; Stoker Jaap

来源：Abdominal Radiology, 2016, 41(10): 1918-1930.

DOI：10.1007/s00261-016-0802-z

• Proctitis
• Crohn disease
• Magnetic resonance imaging
• Rectum
• Inflammatory bowel disease

Multiple features have been described for assessing inflammation in Crohn's disease (CD) in MR enterography, but have not been validated in perianal magnetic resonance imaging (MRI). Retrospectively, we studied which MRI features are valuable in assessing proctitis.
CD patients (aeyen18 years) who underwent colonoscopy (reference standard) and perianal fistula MRI within 8 weeks were included. Seventeen MRI features were blindly scored by three observers and correlated to endoscopy (regression analysis). Reproducibility (multirater kappa, intraclass correlation coefficient) was determined for all three observer pairs. MRI features were considered relevant when significantly correlated to endoscopy for aeyen2 observers, and reproducibility was aeyen0.40 for aeyen2 observer pairs.
Perianal MRI of 58 CD patients were included. Wall thickness, rectal mural fat, creeping fat, and size of mesorectal lymph nodes showed a significant correlation with endoscopy for aeyen2 observers (p = 0.000-0.023, p = 0.011-0.172, p = 0.007-0.011 and p = 0.000-0.005, respectively) with a kappa/intraclass correlation coefficient of aeyen0.60 for aeyen2 observer pairs. Perimural T2 signal and perimural enhancement significantly correlated to endoscopy (all p values aecurrency sign0.05) for all three observers and the reproducibility was aeyen0.40 for aeyen2 observer pairs. Mural T2 signal and degree and pattern of T1 enhancement showed significant correlation to endoscopy for two observers, but with poor to moderate reproducibility.
Wall thickness, mural fat, and mesorectal features (perimural T2 signal, perimural enhancement, creeping fat, and size of mesorectal lymph nodes) had significant correlation to endoscopy and were reproducible in diagnosing proctitis. Some established luminal features in MRE were considered not useful.

• 出版日期2016-10