scholarly journals Can Conventional and Diffusion-Weighted MR Enterography Biomarkers Differentiate Inflammatory from Fibrotic Strictures in Crohn’s Disease?

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 265
Author(s):  
Pietro Valerio Foti ◽  
Mario Travali ◽  
Renato Farina ◽  
Stefano Palmucci ◽  
Maria Coronella ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Mr Enterography ◽  
Reference Standard ◽  
Standard Material ◽  
Luminal Diameter ◽  
Adc Value ◽  
Diffusion Weighted ◽  
And Diffusion ◽  
Bowel Dilatation

Background and Objectives: To retrospectively assess the value of magnetic resonance enterography (MRE) parameters derived from conventional and diffusion weighted imaging (DWI) sequences to differentiate fibrotic strictures from inflammatory ones in adult patients with Crohn’s disease (CD), using surgical specimens as the histopathological reference standard. Material and Methods: Twenty-three patients with CD who had undergone surgical resection of ileal strictures with full-thickness histopathologic analysis within 3 months from preoperative MRE were included. Two radiologists blinded to histopathology in consensus evaluated the following biomarkers on MRE images matched to resected pathological specimens: T1 ratio, T2 ratio, enhancement pattern, mural thickness, pre-stenotic luminal diameter, and apparent diffusion coefficient (ADC). A blinded pathologist graded stricture histological specimens with acute inflammation score (AIS) and fibrosis score (FS). MRE measurements were correlated with the reference standard. Results: Inflammation and fibrosis coexisted in 78.3% of patients. T2 ratio was reduced in patients with severe fibrosis (p = 0.01). Pre-stenotic bowel dilatation positively correlated with FS (p = 0.002). The ADC value negatively correlated with FS (p < 0.001) and was different between FS grades (p < 0.05). The area under the receiver operating characteristic curve for discriminating between none and mild/moderate–severe bowel wall fibrosis was 0.75 for pre-stenotic bowel dilatation (sensitivity 100%, specificity 44.4%) and 0.97 for ADC (sensitivity 80%, specificity 100%). Conclusions: Inflammation and fibrosis often coexist in CD bowel strictures needing surgery. The combination of parameters derived from conventional MR sequences (T2 ratio, pre-stenotic dilatation) and from DWI (ADC) may provide a contribution to detect and grade bowel fibrosis in adult CD patients.

Diffusion-weighted MR enterography for evaluating Crohn’s disease: Effect of anti-peristaltic agent on the diagnosis of bowel inflammation

2016 ◽  
Vol 27 (6) ◽  
pp. 2554-2562 ◽  
Author(s):  
So Hyun Park ◽  
Jimi Huh ◽  
Seong Ho Park ◽  
Seung Soo Lee ◽  
Ah Young Kim ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Mr Enterography ◽  
Diffusion Weighted ◽  
Disease Effect

scholarly journals Quantification of inflammatory activity in patients with Crohn’s disease using diffusion weighted imaging (DWI) in MR enteroclysis and MR enterography

2016 ◽  
Vol 58 (3) ◽  
pp. 264-271 ◽  
Author(s):  
Nora Stanescu-Siegmund ◽  
Yessica Nimsch ◽  
Arthur P Wunderlich ◽  
Martin Wagner ◽  
Reinhard Meier ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Wall ◽  
Mr Enterography ◽  
Normal Bowel ◽  
Apparent Diffusion Coefficients ◽  
Diffusion Weighted ◽  
Mr Enteroclysis ◽  
Adc Values ◽  
Bowel Segments

Background Individual studies have demonstrated the potential of diffusion-weighted magnetic resonance imaging (DWI-MRI) for identifying inflamed bowel segments. However, these studies were conducted with rather small patient cohorts and in most cases by means of MR enterography only. Purpose To demonstrate the feasibility of detecting inflamed bowel segments in a large collective of patients with Crohn’s disease using DWI in MR enteroclysis and MR enterography and to compare the results of both techniques, also considering clinical parameters by means of the Harvey-Bradshaw Index (HBI). Material and Methods Ninety-six patients underwent MRI enteroclysis and 35 patients MR enterography, both with additional DWI. The HBI as well as apparent diffusion coefficients (ADC) in areas of inflamed and normal bowel wall were determined. Thus resulting in 208 bowel segments that were visualized and subsequently statistically analyzed. Results There were no significant differences in ADC values in MR enteroclysis and MR enterography ( P = 0.383 in inflammation, P = 0.223 in normal wall). Areas of inflammation showed statistically highly significant lower ADC values than areas of normal bowel wall ( P < 0.001). An ADC threshold of 1.56 × 10–3 mm2/s can distinguish between normal and inflamed bowel segments with a sensitivity of 97.4% and a specificity of 99.2%. A highly significant correlation could be shown between ADC and HBI values ( P = 0.001). Conclusion DWI-MRI facilitates recognition of inflamed bowel segments in patients with Crohn’s disease and the ADC values show an excellent correlation to the HBI. There were no significant differences in ADC values in MR enteroclysis and MR enterography. An ADC threshold of 1.56 × 10–3 mm2/s differentiates between normal and inflamed bowel wall.

scholarly journals P129 Value of diffusion-weighted magnetic resonance enterocolonography for assessing Crohn’s disease activity

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S201-S202
Author(s):  
V Straksyte ◽  
G Kiudelis ◽  
L Kupcinskas ◽  
I Zaboriene
Keyword(s):  
Crohn’S Disease ◽  
Magnetic Resonance ◽  
Crohn's Disease ◽  
Activity Index ◽  
Characteristic Curve ◽  
Adc Value ◽  
Apparent Diffusion Coefficients ◽  
Diffusion Weighted ◽  
Index Of Severity ◽  
Bowel Segments

Abstract Background We aimed to determine diffusion-weighted imaging (DWI) value to predict active Crohn’s disease (CD) and compare apparent diffusion coefficients (ADC) with endoscopic and conventional magnetic resonance imaging (MRI) CD activity indices. Methods Overall, 229 patients with suspected CD prospectively underwent magnetic resonance enterocolonography (MR-EC) with DWI sequence and ileocolonoscopy. Magnetic resonance activity index (MaRIA), Clermont index, and CD endoscopic index of severity (CDEIS) were calculated. Results Out of 229 investigated patients, the clinical diagnosis of CD was confirmed in 100 persons. Using receiver operating characteristic curve, we showed that DWI score ≥2 had 96.9% sensitivity and 82.3% specificity for diagnosing CD. A threshold of ADC value of 1.30×10–3mm2/s can distinguish between normal and inflamed bowel segments with a sensitivity of 73.8% and a specificity of 98% using Copenhagen diagnostic criteria as the reference standard. While using MaRIA, the threshold of ADC value was established of 1.32 × 10–3 mm2/s with sensitivity and specificity (97.9%, 97.8%). ADC correlated with MaRIA-G (global) (r = -0.69, p = 0.001), Clermont-G (r = -0.722, p = 0.001) and CDEIS (r = -0.69, p = 0.001). Conclusion DWI is a valuable tool which is able to identify inflamed bowel segments as accurate as conventional MARIA score and to discriminate between mild and moderate and severe CD activity.

scholarly journals Comparison of contrast-enhanced and diffusion-weighted MRI in assessment of the terminal ileum in Crohn’s disease patients

2018 ◽  
Vol 44 (2) ◽  
pp. 398-405
Author(s):  
Carl A. J. Puylaert ◽  
Jeroen A. W. Tielbeek ◽  
Peter J. Schüffler ◽  
C. Yung Nio ◽  
Karin Horsthuis ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Terminal Ileum ◽  
Diffusion Weighted Mri ◽  
Diffusion Weighted ◽  
Contrast Enhanced ◽  
And Diffusion
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