这篇综述集中在磁共振成像(MRI)在胃肠道(GIMRI)评估中的作用,分析该领域取得的主要技术进步,如弥散加权成像,分子成像,运动性研究,和人工智能。今天,使用更先进的成像技术进行MRI可以准确评估许多肠道疾病,特别是炎症性肠病和直肠癌;在大多数这些疾病中,MRI对诊断是无价的,分期,和治疗中的疾病监测。一些MRI参数目前被认为是炎症和肿瘤疾病的活性生物标志物。此外,在患有急性或慢性胃肠道疾病的年轻患者中,MRI可以安全地用于许多关键临床情况下的短期随访研究,因为它是无辐射的。功能性胃食管和小肠疾病的MRI评估仍处于起步阶段,但非常有希望。虽然已经建立并广泛用于动态评估肛门直肠和盆底功能障碍,但也已经描述了MRI运动生物标志物。GIMRI仍然存在一些局限性,与高成本和有限的可及性有关。然而,预计技术进步,比如更快的序列,更具体的肠道造影剂,MRI数据的AI分析,并可能增加GIMRI研究的可及性。使用MRI评估肠病的临床兴趣已经非常高,但预计未来几年将大幅增加。
This review focuses on the role of magnetic resonance imaging (MRI) in the evaluation of the gastrointestinal tract (GI MRI), analyzing the major technical advances achieved in this field, such as diffusion-weighted imaging, molecular imaging, motility studies, and artificial intelligence. Today, MRI performed with the more advanced imaging techniques allows accurate assessment of many bowel diseases, particularly inflammatory bowel disease and rectal cancer; in most of these diseases, MRI is invaluable for diagnosis, staging, and disease monitoring under treatment. Several MRI parameters are currently considered activity biomarkers for inflammation and neoplastic disease. Furthermore, in younger patients with acute or chronic GI disease, MRI can be safely used for short-term follow-up studies in many critical clinical situations because it is radiation-free. MRI assessment of functional gastro-esophageal and small bowel disorders is still in its infancy but very promising, while it is well established and widely used for dynamic assessment of anorectal and pelvic floor dysfunction; MRI motility biomarkers have also been described. There are still some limitations to GI MRI related to high cost and limited accessibility. However, technical advances are expected, such as faster sequences, more specific intestinal contrast agents, AI analysis of MRI data, and possibly increased accessibility to GI MRI studies. Clinical interest in the evaluation of bowel disease using MRI is already very high, but is expected to increase significantly in the coming years.