Prospective evaluation of free-breathing diffusion-weighted imaging for the detection of inflammatory bowel disease with MR enterography in childhood population

Dubron, Céline; Avni, Freddy; Boutry, Nathalie; Turck, Dominique; Duhamel, Alain; Amzallag-Bellenger, Élisa

doi:10.1259/bjr.20150840

Cited by 26 publications

(30 citation statements)

References 39 publications

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“…Thus, our study results were along expected lines, but none of these findings is specific for active disease. The statistical analysis did not prove DWI restriction ( Figure 4 ), considered as an active disease finding [ 16 , 20 ], to be a predictive factor for CD diagnosis. Multiple studies evaluated the use of MRE in the differentiation between active and inactive CD [ 8 , 13 ].…”

Section: Discussionmentioning

confidence: 98%

The value of magnetic resonance enterography in diagnostic difficulties associated with Crohn’s disease

et al. 2021

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IntroductionThe diagnosis of Crohn’s disease (CD), one of the inflammatory bowel diseases (IBD), along with ulcerative colitis (UC), is often challenging due to the limitations of small intestine visualisation. Magnetic resonance enterography (MRE) enables imaging of intraluminal and extraintestinal complications without ionizing radiation. The objective of this study is to select CD-related MRE features and determine the feasibility of this technique to indicate a group of patients that should be subjected to more invasive diagnostic procedures.Material and methodsA total of 131 patients (mean age 25) underwent MRE, 60 of whom had been previously diagnosed with CD and 17 with UC. Additionally, 26 patients with suspected IBD and 28 with other or unknown pathologies were included in the study. Radiological reports of MRE examinations, effectuated using a 1.5-T field strength, were retrospectively analysed regarding radiological features of IBD, such as the following: bowel wall thickening, enhancement, comb sign, stricture, enlarged mesenteric nodes, inflammatory infiltration, and abnormal diffusion restriction in diffusion-weighted imaging. The statistical model was based on machine learning of the Kohonen map, together with univariate and multivariate analysis.ResultsThe selected neuron (Neuron 3) incorporated 23 cases of CD, 9 of suspected IBD, 2 patients with UC, and 4 with other pathologies. The statistical analysis identified bowel wall thickening, intestinal stricture, and lymphadenopathy as the 3 MRE findings most associated with Neuron 3 (AUC = 0.919, p = 0.031).ConclusionsBowel wall thickening, stricture, and enlarged mesenteric lymph nodes in MRE are independent predictive factors for CD diagnosis; thus, patients presenting these features should undergo further examinations. MRE constitutes a powerful imaging modality in cases of suspected IBD.

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Section: Discussionmentioning

confidence: 98%

The value of magnetic resonance enterography in diagnostic difficulties associated with Crohn’s disease

et al. 2021

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“…Two pediatric studies compared the accuracy for detection of small bowel lesions between DWI-MRI and CE-MRI, and found that DWI-MRI provided similar or even better performance [23,24]. A recent longitudinal study by Huh et al showed that DWI-MRI could be used to diagnose complete remission and improved inflammation after medical therapy with 76% and 84% accuracy, respectively [25].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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Purpose: The purpose of the study was to compare the performance of contrast-enhanced (CE)-MRI and diffusion-weighted imaging (DW)-MRI in grading Crohn's disease activity of the terminal ileum. Methods: Three readers evaluated CE-MRI, DW-MRI, and their combinations (CE/DW-MRI and DW/CE-MRI, depending on which protocol was used at the start of evaluation). Disease severity grading scores were correlated to the Crohn's Disease Endoscopic Index of Severity (CDEIS). Diagnostic accuracy, severity grading, and levels of confidence were compared between imaging protocols and interobserver agreement was calculated. Results: Sixty-one patients were included (30 female, median age 36). Diagnostic accuracy for active disease for CE-MRI, DW-MRI, CE/DW-MRI, and DW/CE-MRI ranged between 0.82 and 0.85, 0.75 and 0.83, 0.79 and 0.84, and 0.74 and 0.82, respectively. Severity grading correlation to CDEIS ranged between 0.70 and 0.74, 0.66 and 0.70, 0.69 and 0.75, and 0.67 and 0.74, respectively. For each reader, CE-MRI values were consistently higher than DW-MRI, albeit not significantly. Confidence levels for all readers were significantly higher for CE-MRI compared to DW-MRI (P < 0.001). Further increased confidence was seen when using combined imaging protocols. Conclusions: There was no significant difference of CE-MRI and DW-MRI in determining disease activity, but the higher confidence levels may favor CE-MRI. DW-MRI is a good alternative in cases with relative contraindications for the use of intravenous contrast medium.

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“…Moreover, an abnormal DWI signal correlates with the calprotectin level being a marker of bowel inflammation [22]. Another study analysed the effect of DWI on diagnosis of active IBD lesions when compared to gadolinium-enhanced MRE in children [23]. Diffusion-weighted images had higher sensitivity, especially for terminal ileum and ileo-caecal junction region.…”

Section: The Radiological Techniques Used In Inflammatory Bowel Diseasesmentioning

confidence: 99%

Up-to-date overview of imaging techniques in the diagnosis and management of inflammatory bowel diseases

Biernacka

Barańska

Grzelak

et al. 2019

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Radiological examination occupies a significant role, complementary to endoscopic studies, in the diagnostic process of inflammatory bowel disease (IBD). Both ulcerative colitis and Crohn’s disease, due to multiple remissions and relapses, require repetitive examinations to evaluate the disease extent, severity, and response to pharmacological treatment. Whereas the use of barium contrast studies is progressively reduced, plain radiography confirms its utility as a first-line imaging tool for acute abdomen. Computed tomography remains an easily accessible and effective method to demonstrate disease activity and extraintestinal manifestations. However, the related radiation exposure reduces its applicability to urgent situations. Ultrasound and magnetic resonance, with the great advantage of avoiding ionising radiation, are highly recommended to present the complications of IBD. Use of oral and intravenous contrast in computed tomography enterography and magnetic resonance enterography demonstrates IBD involvement in the small intestine wall, which is difficult to assess in other radiological and endoscopic examinations.

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Prospective evaluation of free-breathing diffusion-weighted imaging for the detection of inflammatory bowel disease with MR enterography in childhood population

Cited by 26 publications

References 39 publications

The value of magnetic resonance enterography in diagnostic difficulties associated with Crohn’s disease

The value of magnetic resonance enterography in diagnostic difficulties associated with Crohn’s disease

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

Up-to-date overview of imaging techniques in the diagnosis and management of inflammatory bowel diseases

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