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Clinical role of MR diffusion-weighted imaging in the evaluation of intestinal Crohn's disease and its inflammation activity
Author(s): LAN Xing, WEI Juan, ZHOU Fan, WANG Peng, LU Guangming, HUANG Wei
Pages: 350-
354
Year: 2017
Issue:
4
Journal: Radiologic Practice
Keyword: Intestinal disease; Crohn's disease; Diffusion weighted imaging; Apparent diffusion coefficient;
Abstract: Objective:To assess the value of DWI in the diagnosis of intestinal Crohn's disease (CD) and to evaluate its activity.Methods:The MR enterography (MRE) data of fifty-two patients with histo-pathology proven CD were retrospectively analyzed,mainly concentrated on the DWI and ADC values of terminal ileum,ascending and descending colon.The ADC values of CD invaded as well as normal intestinal wall were measured and compared.The sensitivity and specificity of DWI in detecting the invaded intestinal segment were calculated.Taking CD Activity Index (CDAI) as the reference of activity of the disease,the relation between DWI findings and CD activity was analyzed,as well as the correlation of ADC value and simplified endoscope scoring of CD (SES-CD).Results:Of the 52 patients with CD,there were 30 patients having active CD (CDAI≥150) and 22 cases with CD in paracmasis (CDAI<150).Altogether,156 segments including 63 segments with inflammation,93 normal segments confirmed by endoscopic and pathology were enrolled.The true positive and true negative segments diagnosed by DWI were 60 segments and 79 segments,respectively,with the sensitivity as 95.2 % and specificity as 84.9%.The ADC values of CD invaded segments and normal segments were (1.40±0.27) × 10-3 and (2.57±0.31)×10 3mm2/s,with significant statistical difference (t=21.184,P<0.001).The ADC value of CD in active phase was significantly lower than that of CD in paracmasis [(1.24±0.15)× 10 3mm2/s vs (1.61±0.24)× 10-3 mm2 /s],with significant statistical difference (t'=6.637,P<0.01).The ADC value of inflammation invaded intestinal wall was inversely correlated with SES-CD (r=-0.688,P<0.001).Conclusion:DWI sequence provided helpful information in the diagnosis of the extent of CD.Quantitative analysis of ADC value was also helpful in assessing the activity and severity of the disease.
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