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01.03.2014 | Gastrointestinal

Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn’s disease assessment with histopathology of surgical specimens

verfasst von: Jeroen A. W. Tielbeek, Manon L. W. Ziech, Zhang Li, Cristina Lavini, Shandra Bipat, Willem A. Bemelman, Joris J. T. H. Roelofs, Cyriel Y. Ponsioen, Frans M. Vos, Jaap Stoker

Erschienen in: European Radiology | Ausgabe 3/2014

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Abstract

Objectives

To prospectively compare conventional MRI sequences, dynamic contrast enhanced (DCE) MRI and diffusion weighted imaging (DWI) with histopathology of surgical specimens in Crohn’s disease.

Methods

3-T MR enterography was performed in consecutive Crohn’s disease patients scheduled for surgery within 4 weeks. One to four sections of interest per patient were chosen for analysis. Evaluated parameters included mural thickness, T1 ratio, T2 ratio; on DCE-MRI maximum enhancement (ME), initial slope of increase (ISI), time-to-peak (TTP); and on DWI apparent diffusion coefficient (ADC). These were compared with location-matched histopathological grading of inflammation (AIS) and fibrosis (FS) using Spearman correlation, Kruskal–Wallis and Chi-squared tests.

Results

Twenty patients (mean age 38 years, 12 female) were included and 50 sections (35 terminal ileum, 11 ascending colon, 2 transverse colon, 2 descending colon) were matched to AIS and FS. Mural thickness, T1 ratio, T2 ratio, ME and ISI correlated significantly with AIS, with moderate correlation (r = 0.634, 0.392, 0.485, 0.509, 0.525, respectively; all P < 0.05). Mural thickness, T1 ratio, T2 ratio, ME, ISI and ADC correlated significantly with FS (all P < 0.05).

Conclusions

Quantitative parameters from conventional, DCE-MRI and DWI sequences correlate with histopathological scores of surgical specimens. DCE-MRI and DWI parameters provide additional information.

Key points

• Conventional MR enterography can be used to assess Crohn’s disease activity.

• Several MRI parameters correlate with inflammation and fibrosis scores from histopathology.

• Dynamic contrast enhanced imaging and diffusion weighted imaging give additional information.

• Quantitative MRI parameters can be used as biomarkers to evaluate Crohn’s disease activity.

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Titel: Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn’s disease assessment with histopathology of surgical specimens
verfasst von: Jeroen A. W. Tielbeek
Manon L. W. Ziech
Zhang Li
Cristina Lavini
Shandra Bipat
Willem A. Bemelman
Joris J. T. H. Roelofs
Cyriel Y. Ponsioen
Frans M. Vos
Jaap Stoker
Publikationsdatum: 01.03.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 3/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-3015-7

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Evaluation of conventional, dynamic contrast enhanced and diffusion weighted MRI for quantitative Crohn’s disease assessment with histopathology of surgical specimens