Beurteilung der entzündlichen Aktivität des M. Crohn mit der Hydro-MRT

K. Schunk; A. Kern; C. P. Heußel; P. Kalden; I. Mayer; Th. Orth; R. Wanitschke

doi:10.1055/s-2000-283

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Rofo 2000; 172(2): 153-160
DOI: 10.1055/s-2000-283

ABDOMEN

Georg Thieme Verlag Stuttgart · New York

Beurteilung der entzündlichen Aktivität des M. Crohn mit der Hydro-MRT[∗]

Does Hydro-MRI allow an assessment of the activity in Crohn's disease?K. Schunk¹ , A. Kern¹ , C. P. Heußel¹ , P. Kalden¹ , I. Mayer¹ , Th. Orth² , R. Wanitschke²

¹ Klinik und Poliklinik für Radiologie
² I. Medizinische Klinik und Poliklinik
Klinikum der Johannes-Gutenberg-Universität, Mainz

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Publication History

Publication Date:
31 December 2000 (online)

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Zusammenfassung.

Ziel: Bei Patienten mit M. Crohn soll die Wertigkeit der Hydro-MRT bezüglich der Beurteilung der entzündlichen Krankheitsaktivität untersucht werden. Patienten und Methodik: Bei 63 Crohn-Patienten wurden nach einer oralen Darmkontrastierung atemangehaltene Sequenzen ± intravenöse Gd-DTPA-Applikation akquiriert. Die KM-Anreicherung der Darmwand wurde mit anderen MR-Befunden sowie dem „Crohn's disease activity index” (CDAI) und dem C-reaktiven Protein im Blutserum (CRP) korreliert. Ergebnisse: Nach intravenöser KM-Applikation zeigte die entzündlich veränderte Darmwand im Vergleich zur unauffälligen Dünndarmwand eine signifikant ausgeprägtere Signalzunahme (+ 80 ± 23 % vs. + 43 ± 11 %; p = 8 × 10^-11). Zwischen der prozentualen KM-Mehranreicherung der entzündlich befallenen Darmwand (Δ SI-Anstieg) und anderen MR-Befunden fanden sich positive Korrelationen. Zwischen dem Δ SI-Anstieg und dem CDAI fand sich eine nur schwache Korrelation (r = 0,25; p = 0,046). Zwischen dem Δ SI-Anstieg und dem CRP ließ sich kein statistischer Zusammenhang nachweisen (r = 0,09; p = 0,24). Schlußfolgerungen: Die Hydro-MRT erlaubt eine Beurteilung der entzündlichen Aktivität des M. Crohn.

Purpose: To assess the value of hydro-MRI in the assessment of the activity of Crohn's disease. Materials and Methods: After an oral bowel opacification using 1000 ml of a 2,5 % mannitol solution, axial and coronal breathhold sequences (T₂W HASTE ± FS, contrast-enhanced T₁W FLASH FS) were acquired in 63 patients with Crohn's disease at 1.0 T. The enhancement of the bowel wall was correlated with other MRI findings, with the Crohn's disease activity index (CDAI), and the C-reactive protein (CRP). Results: In Crohn's disease, contrast enhancement of the affected bowel wall is markedly increased in comparison with the normal bowel wall (+ 80 ± 23 % vs. + 43 ± 11 %; p = 8 × 10^-11). Positive correlations could be established between the increase of bowel wall enhancement and other MRI findings. Between the increase of bowel wall enhancement and the CDAI a poor correlation was found (r = 0.25; p = 0.046). There was no statistical correlation between the increase of bowel wall enhancement and the CRP (r = 0.09; p = 0.24). Conclusion: Hydro-MRI allows an assessment of the activity of Crohn's disease.

Schlüsselwörter:

M.& - 8201;Crohn - Orale Darmkontrastierung - Hydro-MRT - Aktivität - Magen-Darm-Trakt

Key words:

Crohn's disease - Oral bowel opacification - Hydro MRI - Activity - Gastrointestinal tract

1 Herrn Prof. Dr. med. M. Thelen zum 60. Geburtstag gewidmet.

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