Comparison of contrast-enhanced and diffusion-weighted MRI in assessment of the terminal ileum in Crohn’s disease patients
Abstract
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. Show more
Permanent link
https://doi.org/10.3929/ethz-b-000331233Publication status
publishedExternal links
Journal / series
Abdominal RadiologyVolume
Pages / Article No.
Publisher
SpringerSubject
Crohn disease; Magnetic resonance imaging; Diffusion magnetic resonance imaging; Contrast media; Comparative studyMore
Show all metadata