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中华腔镜泌尿外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (06) : 414 -418. doi: 10.3877/cma.j.issn.1674-3253.2019.06.013

所属专题： 文献；

临床研究

MR肠道成像及扫描前护理对克罗恩病肠道-泌尿道瘘的诊断价值
杨艳红1, 黄斯韵1, 林锦江1, 钟英奎1, 李雪华1,†()   
  1. 1. 510080　广州，中山大学附属第一医院放射诊断科
  • 收稿日期:2019-07-03 出版日期:2019-12-01
  • 通信作者: 李雪华

Value of MR enterography and pre-scanning nursing care for the characterization of enteric-urinary fistula in Crohn's disease

Yanhong Yang1, Siyun Huang1, Jinjiang Lin1, Yingkui Zhong1, Xuehhua Li1,†()   

  1. 1. Department of Radiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
  • Received:2019-07-03 Published:2019-12-01
  • Corresponding author: Xuehhua Li
  • About author:
    Corresponding Autor:Li Xuehhua, Email:
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引用本文：

杨艳红, 黄斯韵, 林锦江, 钟英奎, 李雪华. MR肠道成像及扫描前护理对克罗恩病肠道-泌尿道瘘的诊断价值[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2019, 13(06): 414-418.

Yanhong Yang, Siyun Huang, Jinjiang Lin, Yingkui Zhong, Xuehhua Li. Value of MR enterography and pre-scanning nursing care for the characterization of enteric-urinary fistula in Crohn's disease[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(06): 414-418.

目的

探讨MR肠道成像（MRE）及扫描前护理对克罗恩病（CD）肠道-泌尿道瘘的诊断价值。

方法

回顾性收集22例行手术治疗并有术前MRE扫描的CD肠道-泌尿道瘘患者临床资料。在MRE图上观察肠道-泌尿道瘘的位置和形态，并在电子病例系统上查阅患者的扫描前护理、扫描方案及手术记录。以术中所见的肠道-泌尿道瘘情况为金标准，分析MRE诊断肠道-泌尿道瘘的优劣势以及扫描前护理工作对其诊断的影响。

结果

22例患者中，MRE诊断为肠道-膀胱瘘者16例和肠道-输尿管瘘者5例，手术诊断为肠道-膀胱瘘者18例和肠道-输尿管瘘者15例。MRE诊断肠道-膀胱瘘的准确性较高（AUC=0.944；P=0.006），但诊断肠道-输尿管瘘的准确性较低（AUC=0.667；P=0.217）。未接受标准扫描前护理的患者MRE诊断肠道-泌尿道瘘的准确性（0/5）远低于接受标准扫描前护理者（12/17） （P=0.010）。

结论

MRE对肠道-膀胱瘘具有较高的诊断价值，但是难以准确诊断肠道-输尿管瘘；标准的MRE扫描前护理可改善图片质量而提高诊断准确率。

关键词: 克罗恩病, 瘘, MR肠道成像, 护理
Objective

To evaluate the diagnostic value of MR enterography (MRE) and pre-scanning nursing care for the characterization of enteric-urinary fistula in Crohn's disease(CD).

Methods

The preoperative MRE of 22 CD patients with enteric-urinary fistulas who underwent surgery were retrospectively analyzed. The location and morphology of the enteric-urinary fistulas were observed on MRE, and the pre-scan nursing care, scan protocol and surgical records were reviewed on the electronic medical record. Using the intraoperative findings of enteric-urinary fistulas as reference standard, the strengths and weaknesses of MRE and the influence of pre-scan nursing care for diagnosing enteric-urinary fistulas were respectively analyzed.

Results

Of 22 patients, 16 had enteric-bladder fistulas and 5 had enteric-ureteral fistulas on MRE, while 18 had enteric-bladder fistulas and 15 had enteric-ureteral fistulas in surgery. The accuracy of MRE was high for the detection of enteric-bladder fistulas (AUC=0.944, P=0.006) but low for enteric-ureteral fistulas (AUC=0.667, P=0.217). The accuracy of MRE in the patients who did not receive standard pre-scan nursing care (0/5) is significantly lower than those who received standard pre-scan nursing care (12/17) (P=0.010).

Conclusion

The diagnostic value of MRE is high for the enteric-bladder fistulas but low for the enteric-ureteral fistula. A standard pre-scan nursing care can improve diagnostic accuracy by enhancing the MR images quality.

Key words: Crohn's disease, Fistula, MR enterography, Nursing
图3 ROC曲线分析显示MRE诊断CD肠道-泌尿道瘘的准确性
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