Dark Lumen Magnetic Resonance Enteroclysis in Combination With Mri Colonography for Whole Bowel Assessment in Patients With Crohnʼs Disease: First Clinical Experience

Abstract

The combination of MRE and MRC could improve the diagnostic value of abdominal MRI evaluation in patients with Crohn's disease. However, MRC can not replace conventional colonoscopy in subtle inflammation assessment.

Feasibility of evaluating Crohn's disease activity at 3.0 Tesla

“…Our hypothesis is supported by earlier studies (2,38) that showed low correlation coefficients between CDEIS and CDAI, and between individual MR parameters and CDAI (28). To our knowledge, seven prospective studies have examined the accuracy of MRI for assessing CD in an adult population using endoscopy as the gold standard (27)(28)(29)(30)(31)(32)(33). However, in all but two of these studies besides CD patients (29,32), also patients with ulcerative colitis (UC) were included.…”

“…In a study by Schreyer et al (32), a sensitivity of 55.1% and specificity of 98.2% were achieved for correct grading of inflammatory activity. Segmental analysis showed correlation coefficients of 0.58 for the terminal ileum between radiological and endoscopic grading, which is in line with our results.…”

“…Mesenteric hypervascularity, which in several studies has been mentioned as indicative of active disease (6,7,31,32), may be more pronounced at 3.0T. It is known that flow appears brighter at 3.0T than at 1.5T due to the longer T1 of the tissues at higher field strength.…”

“…To our knowledge, seven prospective studies have examined the accuracy of MRI for assessing CD in an adult population using endoscopy as the gold standard (27)(28)(29)(30)(31)(32)(33). However, in all but two of these studies besides CD patients (29,32), also patients with ulcerative colitis (UC) were included. One radiological and one endoscopic scoring system for inflammatory activity (no disease, mild disease, or marked disease) were used for the two subgroups of patients.…”

“…However, before MRI can be considered an alternative for endoscopy in CD, it should be firmly established that in addition to detecting disease activity, MRI is capable of revealing both the severity and the exact location of disease. A few prospective studies have compared MRI with endoscopy regarding the severity of disease, but only the five most recent of these studies also analyzed the accuracy of MRI for localizing disease (27)(28)(29)(30)(31)(32)(33). The results of these studies were conflicting, and the reported sensitivities and specificities varied widely from approaching endoscopic accuracy to considerable over-or underestimation of disease.…”