目的探讨磁共振肠管成像(MRE)评估小肠克罗恩病(CD)活动性的价值。方法对肠镜确诊的29例CD患者进行MRE检查。计算自旋回波螺旋桨技术脂肪抑制T_2WI序列末端回肠炎症肠壁和邻近正常小肠肠壁、竖直肌的T_2信号强度的比值。将动脉期3D肝脏快速容积成像序列末端回肠炎症肠壁和相同部位的平扫T_1信号强度做对比,分别对T_1和T_2比值评分(0~3分)。评估末端回肠炎症肠壁的厚度、淋巴结、肠管周围T_2信号、齿梳征、肠管变形和溃疡、息肉的分值(0~3分)。运用简化版CD肠镜评分方法(0~12分)对CD末端回肠急性活动性炎症进行评分。分析MRE活动性指标和肠镜急性炎症评分相关性。导出MRE回归方程并计算MRE模型预测急性炎症的受试者工作特征曲线。结果管壁厚度,炎症肠壁T_2/邻近正常肠壁T_2(T_2ratio),动脉期炎症肠壁T_1/平扫炎症肠壁T_1(T_1ratio),肠管周围T_2信号,管壁溃疡和息肉,齿梳征与肠镜急性炎症活动性评分具有一定的相关性。导出回归方程:SES-CD(the simple endoscopic score for crohn’s disease)=-0.268+0.793×T1ratio+1.977×肠管周围T_2信号+0.643×肠壁厚度(R squared=0.662)。MRE模型检测急性炎症的能力,敏感性82.4%,特异性83%,曲线下面积0.919(95%CI 0.84,0.998)。结论 T1ratio、管壁厚度、齿梳征、肠管周围T_2信号能够较好地预测肠壁炎症活动性;导出的MRE模型能够准确的预测CD急性炎症(AUC>0.9)。 Objective To investigate the value of magnetic resonance enteral imaging (MRE) in assessing the activity of small bowel Crohn’s disease (CD). Methods MRE was performed on 29 CD patients confirmed by colonoscopy. The ratio of T 2 signal intensity in the intestinal wall and the vertical muscle of the intestine and the adjacent normal small intestine of the T 2 WI sequence was calculated by spin echo propeller technique. The signal intensity of T_1 signal at the same site and the intestine wall of the terminal ileal inflammatory mass in rapid 3D volumetric imaging of arterial phase was compared. The ratio of T_1 to T_2 was scored (0-3). Assess the thickness of the intestinal wall of the terminal ileum, lymph nodes, T 2 signals around the intestine, tooth comb, bowel deformity and ulceration, and score of polyps (0-3). Acute CD inflammation of the distal ileum was scored using a simplified version of the CD colonoscopy score (0-12). The correlation between MRE activity index and acute inflammation score of colonoscopy was analyzed. Derived MRE regression equation and calculated the MRE model predicts the acute inflammation of the working characteristic curve of the subjects. Results The thickness of tubular wall, T 2 / T 2 ratio of inflammatory bowel wall, T 1 / T 1 of inflamed bowel wall, T 2 signal in peri - intestinal tract, ulceration of gastric wall and polyp, And enterocolitis acute inflammatory activity score has a certain correlation. The regression equation was derived: SES-CD = -0.268 + 0.793 × T1ratio + 1.977 × T_2 signal around the intestine + 0.643 × R squared = 0.662. The ability of the MRE model to detect acute inflammation was 82.4% sensitive and 83% specific, with an area under the curve of 0.919 (95% CI 0.84, 0.998). Conclusion T1ratio, wall thickness, tooth combing, T_2 signal around the intestine can predict the activity of intestinal wall inflammation better. The derived MRE model can accurately predict the acute inflammation of CD (AUC> 0.9).