J Gastroenterology:磁共振成像可以评估克罗恩病患者肠粘膜是否愈合并降低手术风险

2018-10-02 MedSci MedSci原创

内镜下粘膜愈合被认为是克罗恩病(CD)的最佳治疗终点,因为它与更长的临床缓解结果相关。因此,有关研究人员探究了是否可以使用磁共振成像(MRI)来评估肠粘膜的愈合(BWH),并以此预测克罗恩病长期的预后结果。

背景
内镜下粘膜愈合被认为是克罗恩病(CD)的最佳治疗终点,因为它与更长的临床缓解结果相关。因此,有关研究人员探究了是否可以使用磁共振成像(MRI)来评估肠粘膜的愈合(BWH),并以此预测克罗恩病长期的预后结果。

方法
研究人员从两项前瞻性研究(总共 174名患者)中进行了回顾性分析。所有患者均被确诊为克罗恩病,并且通过MRI检测。完全的BWH定义为无节段性MaRIA> 7或无节段性Clermont评分> 8.4且BWH为无节段性MaRIA> 11或无节段性Clermont评分> 12.5。临床无皮质类固醇使用(CFREM)被定义为持续的临床缓解,治疗策略的改变,患者需要住院或行CD相关手术则被定义为临床复发。Logistic回归模型用来寻找影响粘膜愈合的影响因素。

结果
总共有63名CD患者接受了平均随访时间为4.8±3.1年回顾性研究。在多变量分析中,研究人员发现完全的BWH或BWH与MaRIA评分和CFREM相关[OR = 4.42(2.29-26.54);p= 0.042;OR = 3.43(1.02-27.02);p= 0.047]。在多变量分析中(n= 63例患者),完全BWH或BWH与手术风险降低相关[HR = 0.16(0.043-0.63);p= 0.008,HR = 0.24(0.07-0.77);p= 0.017]

结论
研究人员证实,克罗恩病患者可以采用MRI检测进行MaRIA并判断是否存在粘膜愈合,而粘膜愈合与克罗恩病的长期临床缓解显着相关。

原始出处:

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    2019-05-31 guoyibin
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    2019-08-20 许安
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    2018-10-06 121832a9m88暂无昵称

    学习了

    0

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CLIN CANCER RES:MRI检测肿瘤相关巨噬细胞

恶性肿瘤中的肿瘤相关巨噬细胞与肿瘤侵袭性有关且可以作为肿瘤免疫治疗的新的靶点。新的靶向肿瘤相关巨噬细胞的免疫治疗正在进行临床试验,使用非侵袭性的影像学检查方式检测并评估肿瘤相关巨噬细胞很重要。CLIN CANCER RES近期发表了一篇文章,研究ferumoxytol增强MRI是否可以检测淋巴瘤和骨肉瘤中的肿瘤相关巨噬细胞。

Radiology:“深度学习”用于膝关节MRI可以达到很好的软骨损伤检测诊断效果

本项研究旨在评估用深度学习的方法检测膝关节磁共振中软骨病变(包括软骨软化,纤维化,局部缺损,软骨退变引起的弥漫性变薄和急性软骨损伤)的可行性。

NEJM:MR指导下醒后卒中的静脉溶栓得到确认

阿替普酶静脉溶栓时发病4.5h内急性缺血性卒中的标准治疗方案。在14-27%的卒中患者中不知道发病时间,最常见的原因是醒后卒中。这些患者通常被排除在静脉溶栓治疗之外,仅部分患者适合机械性血栓切除术。

Radiology:动态增强乳腺MRI评估新辅助化疗后残余肿瘤大小

本项研究旨在探讨利用动态增强(DCE)乳腺MRI对新辅助化疗(NAC)后残留肿瘤大小的准确性。

JAMA Neurol:自发性脊髓损伤患者特征及诊断标准

研究基于确诊的自发性脊髓损伤患者特点,提出了自发性脊髓损伤临床、实验室以及MRI诊断标准,对临床实践及患者针对性治疗提供了依据