收稿日期: 2025-04-03
网络出版日期: 2025-08-11
基金资助
国家自然科学基金项目(82270693);广东省基础与应用基础研究基金项目(2023A1515010388);广东省基础与应用基础研究基金项目(2023B15 15020070)
Multimodal MRI⁃based neurophenotype correlated to structural bowel damage in Crohn′s disease
Received date: 2025-04-03
Online published: 2025-08-11
目的 通过多模态脑MRI分析克罗恩病（Crohn′s disease， CD）患者的神经表型，揭示肠道损伤相关的神经变化。 方法 前瞻性纳入在1周内同时接受了脑MRI、MR肠道成像和结肠镜检查的CD患者。采用Lémann指数（LI）定量评估肠道累积性结构损伤，根据4.8的截断值将CD患者分为伴有肠道损伤（LI > 4.8）组和无肠道损伤（LI ≤ 4.8）组。通过从多模态脑MRI中提取的一阶特征中选择关键特征，在训练队列中开发了用于表征CD肠道损伤患者神经变化的神经表型模型，并在独立测试队列中进行了验证。 结果 本研究纳入了109例CD患者（伴有肠道损伤组51例，无肠道损伤组58例）。伴有肠道损伤组的神经表型模型评分为0.785（0.506， 0.945）分，无肠道损伤组的神经表型模型评分为0.155（0.093， 0.394）分，两组的评分差异有统计学意义（P < 0.001）。神经表型模型表现出良好的性能，在训练、验证和测试队列中，受试者工作特征曲线下面积（AUC）范围为0.824 ~ 0.918（均P < 0.05）。 结论 神经表型模型揭示了伴有肠道损伤的CD患者所发生的神经变化，可作为监测肠道损伤严重程度的肠外标志物。
方壮念 , 张若楠 , 黄丽莉 , 申晓迪 , 郑卿珠 , 王杨迪 , 李雪华 , 李周雷 , 林少春 . 多模态MRI表征的神经表型与克罗恩病肠道损伤的相关性[J]. 实用医学杂志, 2025 , 41(15) : 2398 -2405 . DOI: 10.3969/j.issn.1006-5725.2025.15.016
Objective To characterize neurological alterations associated with structural bowel damage in patients with Crohn′s disease （CD） through radiomics-assisted neurophenotyping， utilizing multiparametric brain MRI. Methods This prospective study enrolled patients with CD who underwent brain MRI， MR enterography， and ileocolonoscopy within one week. The Lémann Index was used to quantitatively assess cumulative structural bowel damage. CD patients were stratified into two groups based on a cutoff value of 4.8： those with bowel damage （LI > 4.8） and those without bowel damage （LI ≤ 4.8）. A neurophenotype model was developed to characterize the neural changes associated with bowel damage in CD. Key features were selected from first-order features extracted from multiparametric brain MRI in the training cohort and validated in an independent test cohort. Results The final study population comprised 109 patients， including 51 individuals with bowel damage and 58 without bowel damage. The neurophenotype model scores were 0.785 （95%CI： 0.506 ~ 0.945） in the bowel damage group and 0.155 （95%CI： 0.093 ~ 0.394） in the non-bowel damage group， showing a statistically significant difference between the two groups （P < 0.001）. The developed model exhibited strong discriminative performance， with area under the receiver operating characteristic curve （AUC） values ranging from 0.824 to 0.918 across the training， validation， and test cohorts （all P < 0.05）. Conclusion Our radiomics-assisted neurophenotype analysis reveals neural alterations in CD patients with bowel damage， which may indicate extraintestinal manifestations associated with cumulative intestinal injury.
Key words： Crohn′s disease; brain-gut axis; bowel damage; Lémann index
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