Active Crohn's Disease in the small bowel: Evaluation by diffusion weighted imaging and quantitative dynamic contrast enhanced MR imaging

Oto, Aytekin; Kayhan, Arda; Williams, Joshua T.B.; Fan, Xiaobing; Yun, Laura; Arkani, Sanaz; Rubin, David T.

doi:10.1002/jmri.22435

Cited by 192 publications

(142 citation statements)

References 36 publications

(55 reference statements)

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“…well-known imaging features are evaluated using a combination of unenhanced and post-contrast T1-weighted images, usually with fat suppression, T2-weighted images with and without fat suppression, and more recently diffusion-weighted images [16][17][18][19]. However, there are times when these sequences are not completely diagnostic for inflammatory bowel disease, and having additional imaging criteria would be useful.…”

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confidence: 99%

Erratum to: Identifying decreased peristalsis of abnormal small bowel segments in Crohn’s disease using cine MR enterography: the frozen bowel sign

et al. 2014

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Purpose: The purpose of this study was to evaluate whether affected bowel in Crohn's disease patients can be identified by observing decreased peristalsis (frozen bowel sign) using cine balanced steady-state free precession (cine BSSFP) images. Materials and methods: 5 radiologists independently reviewed cine BSSFP sequences from randomized MR Enterography (MRE) exams for 30 normal and 30 Crohn's disease patients, graded overall small bowel peristalsis from slowest to fastest, and graded peristalsis for the most abnormal small bowel segment. Sensitivity and specificity of the frozen bowel sign for diagnosing Crohn's disease were calculated. T tests of the peristalsis difference between abnormal segments and overall small bowel were conducted. Results: For 5 readers, the sensitivity and specificity of cine BSSFP of the frozen bowel sign for diagnosing Crohn's disease ranged from 70% to 100% and 87% to 100%, respectively. There were significant differences in peristalsis between abnormal small bowel segments and the overall small bowel for Crohn's patients, but not in the overall small bowel between normal-MRE patients and Crohn's disease patients. Conclusion: Abnormal Crohn's small bowel segments have significantly decreased peristalsis compared to normal small bowel, which can be identified using cine BSSFP sequences as the frozen bowel sign.Key words: MR enterography-Small bowelPeristalsis-Motility-Cine MRI-Crohn's disease Erratum to: Abdom Imaging DOI 10.1007/s00261-014-0258-yThe original publication did not include the images pertaining to the supplementary video files. This has been corrected in this article.Using MR enterography (MRE) to diagnose inflamed small bowel segments in patients with Crohn's disease requires a multiparametric approach, evaluating imaging features from several different pulse sequences. The most commonly used imaging features are well established in the literature for both CT scan [1][2][3][4] and MRI [5][6][7][8][9][10][11][12][13][14][15]. These include bowel wall thickening, bowel wall edema, perienteric edema and fluid, and mucosal, transmural, and possibly serosal hyperenhancement after intravenous contrast or gadolinium administration. With MRE, these Electronic supplementary material: The online version of this article

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Erratum to: Identifying decreased peristalsis of abnormal small bowel segments in Crohn’s disease using cine MR enterography: the frozen bowel sign

et al. 2014

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“…The potential of DCE-MRI as a biomarker for measuring antiangiogenic effects of cancer therapy can also be used in bowel imaging for evaluating the vascularization of intestinal segments and likewise for evaluating therapy response in both chronic inflammatory bowel diseases and in tumors of the bowel [49,50]. In a study involving 18 patients, Oto et al showed that combining DCE-MRI with new methods of diffusion-weighted imaging (DWI) provides a good quantitative measure for differentiating acutely inflammatory changes in the small intestine from normal intestinal segments [35]. However, DWI was even superior to DCE-MRT in this endeavor.…”

Section: Dynamic Contrast Enhanced (Dce) Mrimentioning

confidence: 99%

Magnetic Resonance Imaging of the Bowel: Today and Tomorrow

Kinner

Hahnemann

Forsting

et al. 2015

Fortschr Röntgenstr

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Magnetic resonance imaging of the small bowel has been feasible for more than 15 years. This review is meant to give an overview of typical techniques, sequences and indications. Furthermore, newly evaluated promising techniques are presented, which have an impact on the advance of MR imaging of the small and large bowel. Key Points: ??T2-weighted sequences both with and without fat saturation and T1-weighted fat saturated sequences prior to and following intravenous injection of a gadolinium-based contrast medium contitute the basics for bowel MR imaging. ??Newer MR applications, such as diffusion-weighted imaging or contrast-enhaced dynamic sequences supply addtional information; they should thus be integrated in a regular sequence protocol f?r bowel MRI. ??Additional new modalities like motility imaging and PET/MRI have to be evaluated in future studies. Citation Format: ??Kinner S, Hahnemann ML, Forsting M et?al. Magnetic Resonance Imaging of the Bowel: Today and Tomorrow. Fortschr R?ntgenstr 2015; 187: 160???167

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“…The technique may be useful in determining pathology in the liver (degree of cirrhosis/fibrosis), kidneys (lesion characterization, renal failure, pyelonephritis), pancreas (pancreatitis and pancreatic cancer), bowel (Crohn's disease), and uterus (endometriosis) [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] . In a recent meta-analysis, Li et al [19] has shown a potential future role for this type of sequence to assess for cancers within the liver.…”

Section: Introductionmentioning

confidence: 99%

Impact of field strength and RF excitation on abdominal diffusion-weighted magnetic resonance imaging

Riffel¹,

Rao²,

Haneder³

et al. 2013

WJR

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AIM:To retrospectively and prospectively compare diffusion-weighted (DW) images in the abdomen in a 1.5T system and 3.0T systems with and without twochannel functionality for B1 shimming.METHODS: DW images of the abdomen were obtained on 1.5T and 3.0T (with and without two-channel functionality for B1 shimming) scanners on 150 patients (retrospective study population) and 10 volunteers (prospective study population). Eight regions were selected for clinical significance or artifact susceptibility (at higher field strengths). Objective grading quantified signal-to-noise ratio (SNR), and subjective evaluation qualified image quality, ghosting artifacts, and diagnostic value. Statistical significance was calculated using χ 2 tests (categorical variables) and independent two-sided t tests or Mann-Whitney U tests (continuous variables). RESULTS:The 3.0T using dual-source parallel transmit (dpTX 3.0T) provided the significantly highest SNRs in nearly all regions. In regions susceptible to artifacts at higher field strengths (left lobe of liver, head of pancreas), the SNR was better or similar to the 1.5T system. Subjectively, both dpTX 3.0T and 1.5T systems provided higher image quality, diagnostic value, and less ghosting artifact (P < 0.01, most values) compared to the 3.0T system without dual-source parallel transmit (non-dpTX 3.0T). CONCLUSION:The dpTX 3.0T scanner provided the highest SNR. Its image quality, lack of ghosting, and diagnostic value were equal to or outperformed most currently used systems. © 2013 Baishideng. All rights reserved.Key words: Abdominal imaging; Diffusion weighted; 3.0T; Radiofrequency excitation; Signal-to-noise ratio Core tip: With the popularity of 3.0T imaging systems, radiologists have commonly found limitations in abdominal imaging with diffusion-weighted imaging (DWI) secondary to B1 in homogeneity artifacts at these higher magnet strengths. Because artifacts disturb diagnostic value of abdominal DWI, 1.5T systems have been mainly used for this particular purpose. However, newer techniques involving 3.0T using dual-source parallel radiofrequency (RF) excitation with parallel transmission and independent RF shimming have recently been developed which may succeed in addressing such limitations. Our study illustrates both the objective and subjective utility in the abdominal distribution while imaging under a 3.0T system which incorporates dualsource RF excitation.

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Active Crohn's Disease in the small bowel: Evaluation by diffusion weighted imaging and quantitative dynamic contrast enhanced MR imaging

Cited by 192 publications

References 36 publications

Erratum to: Identifying decreased peristalsis of abnormal small bowel segments in Crohn’s disease using cine MR enterography: the frozen bowel sign

Erratum to: Identifying decreased peristalsis of abnormal small bowel segments in Crohn’s disease using cine MR enterography: the frozen bowel sign

Magnetic Resonance Imaging of the Bowel: Today and Tomorrow

Impact of field strength and RF excitation on abdominal diffusion-weighted magnetic resonance imaging

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